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Your Anxiety Toolkit - Anxiety & OCD Strategies for Everyday

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Your Anxiety Toolkit - Anxiety & OCD Strategies for Everyday
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Now displaying: Page 6
Oct 21, 2022

SUMMARY: 

In This Episode:

  • What to do what your chronic illness causes anxiety 
  • The Difference between POTS and anxiety. 
  • How to manage POTS related anxiety 
  • What is an “Adrenaline Surge”? 
  • The Treatment for POTS and Anxiety 
  • POTS AWARENESS MONTH



Links To Things I Talk About

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. 

Spread the love! Everyone needs tools for anxiety...

If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

EPISODE TRANSCRIPTION

This is Your Anxiety Toolkit - Episode 307. 

Welcome back, everybody. I am so thrilled to be here with you today. As most of you may know, it is OCD Awareness Month or Awareness Week. It’s just passed, and that’s something I’m so passionate about advocating for. But in addition to that, it’s also Postural Orthostatic Tachycardic Syndrome Awareness Month. For those of you who don’t know, I suffer from postural orthostatic tachycardic syndrome. We call it POTS for short. I’ve had multiple people ask me to do an episode about when chronic illnesses cause anxiety, and I thought this is probably the best week to do it. Not only is it awareness week or awareness month for POTS, but I actually have had a little blip in my own recovery in my POTS. So, I wanted to share with you my story and share with you how I’m handling the anxiety and health anxiety and stress and grief of that, and also just address some tools that have worked for me and that I’m hoping will work for you as well. If you have a chronic illness or even if you don’t, I think that these are really core skills that we need to practice just in regards of managing daily stress as well. 

You know what, before we do that, let’s go and do the “I did a hard thing” because this one is actually really touching and I would really like to feature. This was actually an email we received. I love getting your emails. If you guys are not on our newsletter list, please do go and sign up for our newsletter. We do give you access to the whole series. I created a whole website for the six-part mental compulsion series. It will be private just for people who sign up for the newsletter, and it’s got some amazing additional resources, PDFs, links that you really should check out. So, if you want to sign up for that, head on over to CBTSchool.com and you can sign up for our newsletter. 

This person said:

“I took a big leap of leaving my family and moving to China on my own.” Now, I totally resonate with this because I am in America on my own, even though I have my family. Leaving your home country is a big deal. It’s a huge deal. They go on to say, “The only thing, I haven’t been home to see my family in over three years, and I’ve been struggling so much. We hadn’t had a holiday in over two years, and I had been stuck in our complex for months. It was really, really hard. We finally were allowed out of our city, so we decided to go to Yunnan Province.” Hopefully, I pronounce that okay. “I was so worried that my OCD would come in hard and stop me from enjoying this amazing holiday we had planned for. I was strong and I did the hard things, thanks to you. I did a six-day hike at the start of the Himalayas, and I’m like, ‘Holy moly, that is amazing.’ I got engaged on Tiger Leaping Gorge. I ran down a bear and wolf-infested forest, and I slept in a tiny house next to pigs and cows.” What an adventure. “Kimberley, thank you. You have given me strength I needed. You are my inspiration.”

This is what I mean by why I love the “I did a hard thing” because sometimes the hard thing is getting out of bed. Sometimes the hard thing is facing a fear that you know is in your daily life. But sometimes your fear is like living a life according to your values and doing some pretty huge, openhearted things. And so, I absolutely love this “I did a hard thing.” Thank you so much, Leanne, for submitting this because there was something about it that just made me giggle like, holy moly, you really packed in some adventure into a short period of time, and well-deserved after being in a complex for so many months and years. Thank you so much for leaving that here in my inbox. 

Real quick, let’s do the review of the week so that we can head on over. This one is from Young Math Mama and they said:

“BEST podcast for a daily mindset reset. This podcast was recommended to me by my therapist, and it is one of my favorite ‘homework assignments’ to help me have a good mindset and feel inspired to try my best. I’ve learned so much great information from Kimberley, but the most important thing, in my opinion, is that I feel motivated to improve one small thing every time I listen. I’m taking better care of myself, which helps me take better care of my family.”

Literally, Young Math Mama, that is the absolute goal of this. I consider myself part therapist and part coach. I do a lot of coaching in my work and hopefully, I inspire you and motivate you all as well. Thank you so much, Young Math Mama, for submitting, and also Leanna. 

307 When Your Chronic Illness Causes Anxiety Your anxiety toolkit

Update On My Pots/Chronic Illness

Okay, so let me give you a little background here. I haven’t shared this with you because I actually didn’t feel it was appropriate at the time for me to share, but I will share it now. As you guys know, I did a whole podcast about health anxiety, and this whole shocking episode where I had to get my teeth removed, one of my teeth got pulled out. Interestingly, since I had that infection in my tooth and I had it removed, almost all of my POTS symptoms went away. And the reason I didn’t want to share that, which is strange in hindsight why I wouldn’t want to share that, is number one, I wasn’t convinced it was long-term. Number two, I was really concerned that saying that would be really disheartening to some people who are still really struggling. Number three, I was a little worried. I had a bit of a placebo effect if I’m not going to lie. The doctor said it could actually help my POTS and then when it did, I was a little bit like, “Oh, is this the placebo?” I was just waiting for the shoe to drop, which is really not good practice. I wish actually now in hindsight I didn’t do that, but that is the way it played out. 

I have actually had an almost full remission. I do have some bad days. I do have some bad blood pressure days. But I was able to stand for the first time in many years. What I mean by “stand” is the day that I actually realized that I was in recovery from that. In the mornings, I always fill up my kids’ drink bottles and we have one of those filters in the fridge. And usually, it takes probably like 45 seconds, maybe a minute to fill up a drink bottle. But because I can’t stand up for very long or I get really dizzy and I can faint, it usually takes me two goes to fill up a drink bottle. I would fill it up for maybe 20 seconds, then I would go sit down just for a minute or two. I could feel myself get less dizzy and then I would go to do it again. 

You Must Find Rhythms

I have found a rhythm in my life, that’s how debilitating it is. But I had found these rhythms and routines in my life to where I could still fill up my kids’ drink bottles and no one needed to know that I was dizzy. I had found routines to mask it and I’d found routines so I could get through the day. And then I started to notice, oh my God, I’m halfway through filling up the drink bottle and I don’t need to sit down. I could actually fill this whole drink bottle without feeling really dizzy and nauseous, which to you might seem like an easy part of the day, but to me, that’s just a luxury I didn’t have for two years. So, I’ve been so thrilled and so overjoyed and actually really protective of my body because I’m like, “Oh my gosh, I’m in recovery. I’m really doing so well.” 

And then really why the “I did a hard thing” segment resonated with me is because when I came back from Australia, I was so happy and just my heart was so full and we hit the ground running. We really hit the ground running. My daughter started middle school, my son started second grade. They’re in two different schools now. My husband had gone back to another job. We’d just had some house remodeling done. The house was a disaster. We’d had a couple of other stressful events happen. About three weeks ago, I had gotten some really scary news about a loved one. I remember sitting on the couch and just being overwhelmed with anxiety. A massive cortisol, adrenaline surge just went through my body because I was really worried the lasted several days and then I didn’t sleep very well for a few days and then I stopped exercising as much as I was and probably didn’t drink enough water, which is all these things are really important if you have POTS. And I had also not kept up with how much salt I need to eat. I need to eat the most disgusting degrees of salt. It’s a common treatment for POTS. Most people are encouraged not to eat a lot of salt. People with POTS usually have to eat an immense amount of salt. 

My Pots Relapse

Unfortunately, I just started to have all of my symptoms returned. All of them I can manage, but the one that I’m struggling with the most is what they call an “adrenaline surge.” It’s common for people who have POTS. It just feels like you’re having a panic attack, but you’re not having a panic attack. You’re not worried about anything. I think that all of the stress and me loosening my recovery treatment is what caused it. But all of a sudden, I remember I woke up at three in the morning and I thought I was having a panic attack, but it was, now I understand, an adrenaline surge. It was just like someone had injected me with adrenaline and cortisol. At that time, I was like, “This makes sense. We’ve just had a couple of some scary things happen and life is pretty stressful. I’m obviously having a panic attack.”

So, first I want to teach you or show you or demonstrate to you that even though I had woken up in the middle of the night with a panic attack, I used every single one of my tools. I was like, “All right, brain, thank you for waking me up and bringing this to my attention in the middle of the night. There is nothing I can do about it right now. I’m just going to let you be there and we’re going to lay here until you’re ready to leave. You don’t have to leave if you don’t want to.” It took about two hours, three hours, which is pretty long and strange. I was like, “This is a bit strange.” 

When Your Chronic Illness Causes Anxiety & Panic

But then the next night, again, all day feeling anxious, on edge, but also using all my tools. Like, “It’s cool, anxiety can come along, no big deal, I’m cool with it” kind of thing. And then next night, wake up in the middle of the night at 11 o’clock because I go to bed pretty early. 11:00 PM, massive panic, adrenaline surge. Oh my gosh. Okay, now what? I get up and I’m like, “Something is up. I’m obviously struggling.” I do what an average person would do, would be like look around and be like, “What’s going on with me? Is there something really anxiety-provoking that’s going on? Should I be worrying about something? Is this a sign?” And then I was like, “No, no, no, I’m going to use my tools.” This happened for several days until I realized this actually could be just generalized anxiety because I do struggle sometimes with generalized anxiety, but I actually think this is a part of my POTS. So, I did some research and spoke to a doctor and yes, it is in fact a part of my POTS symptoms and it’s one that I didn’t have before. 

But the reason I’m sharing this with you today is, this is actually so common for people with chronic illnesses. If you have a chronic illness, there are these weird things that happen to your body and then it’s so easy just to chalk it up as like, “Oh, I’m having a panic attack,” or “I’m having anxiety.” And then you start panicking and having anxiety. If you’re not careful, you’ll start to do hypervigilant behaviors and avoidant behaviors and mental compulsions, and then it’s a full-blown anxiety disorder. 

Pots And Anxiety: The Dreaded Adrenaline Surge

If there’s one thing I have learned from having a chronic illness is to be so skilled with physical sensations that show up in my body because it can seem so similar to anxiety – dizziness, lightheadedness, agitation, feeling like you’re going to faint. These are all symptoms of POTS, but they’re also symptoms of anxiety. POTS and Anxiety can feel almost exactly the same. So, I’ve had to become very, very skilled. And I use the word “skilled” because this is not an innate thing I know. I had to practice what I preach and I had to be very objective, not subjective about what’s going on, and go, “Okay, you’re having dizziness. It could mean that you’re going to faint, but it also could mean you’re anxious.” So, let’s actually be really skilled in how we respond to this. Or you’re having a panic attack. In this case, you’re having a massive adrenaline surge is what they call it in the POTS world. You’re having this adrenaline surge, it could be a panic attack and it could be your POTS. Let’s work at being very logical and wise in our response to it. Let’s not be responding to it as if it’s a catastrophe or that there’s actually danger. 

This has been so key for me. What I have found, and this is literally as we speak this week and I can say to you as we speak right now, I actually am having a massive adrenaline surge as we speak. It is so easy to interpret it as something is wrong, there must be danger, we’ve got to get out of here. But I’m working at just allowing it to be there and going, “Thank you, brain, for setting off this alarm. I understand. I’m going to allow it to be there.”

The reason I’m sharing this with you and the reason I actually had scheduled to do this recording tomorrow, but today’s the perfect day to do it because I’m actually in quite a lot of suffering right now. It’s pretty painful. It’s pretty uncomfortable. I’m at like an eight 8 of 10 anxiety level, maybe even a 9 depending on where I’m at. I’m just actually going to go about my day. As I speak to you, I’m actually in a pretty big degree of suffering and I just want to be completely real with you. The reason, again, that I wanted to record this today is I was getting ready for work and I started to notice, I was putting all these black clothes on because I don’t feel so great. And I was like, “Wait a second, this is how invasive this can be in that I’m actually choosing black clothes. Not that there’s anything wrong with black clothes, but I’m choosing it because my body feels so uncomfortable. What could I do right now to fully embrace joy, fully just embrace the fact that it’s here?” 

Choosing Your Values

I have this bright, yellow dress that’s like a full circle dress. If you did a spin, it would go into a full circle and I love this skirt. I was like, you know what? I’m going to wear my yellow skirt today. Today is a perfect day to wear my yellow skirt, even though my body is having a massive reaction. My body is obviously in some kind of response to something, chronic illness-wise, and my body wants me to panic. My body wants me to be hypervigilant. My body and my brain want me to tighten up my whole body. But I’m going to put on this yellow skirt and I’m going to sit down with my friends, you guys, and I’m going to talk about this thing that I have to handle. 

As I’m sharing about this, I’m just going to pause here for a second because it brings me to tears. I’m in a lot of pain emotionally. But in that pain, if you could see me right now, I actually have a huge smile on my face because I am so grateful that I gave myself the opportunity to practice these skills because they are actually reducing how much suffering I could have. I remember when I first had these symptoms that I did go into hypervigilance and panic because I was like, “Something is seriously wrong. Something is really wrong. We have to fix it. We’ve got to go to the emergency room.” And now I have these skills to where I’m not actually increasing my suffering by doing all of those compulsive behaviors. And that is key when you have a chronic illness. 

Treatment For Pots And Anxiety (and other chronic illnesses)

All the research I have done shows that having a chronic illness requires medical attention and therapy. Cognitive behavioral therapy, I did a whole bunch of research in prep for this, a whole bunch of research. If you have POTS, they recommend cognitive behavioral therapy. That’s because along with having a chronic illness comes anxiety and depression and other emotions. Along with having other chronic illnesses comes anxiety and depression, diabetes, Crohn’s disease, celiac disease. It could be even just having a chronic illness of having a disorder. A mental health disorder also creates a lot of anxiety in your life. This is key. I’m just so grateful that I have the ability to practice these skills and the ability to just sit in the mud. I am just sitting in the mud today. That’s what I’m doing. I’m so grateful that I have those skills and I really want to teach you guys those skills by modeling to you today. So, let’s break it down. 

When you have anxiety, whether it’s in association to a chronic illness or it’s just regular anxiety, what I’m going to encourage you to do is do nothing at all. It’s actually quite easy when you think about it, but it’s actually really hard at the same time, is to do nothing at all different. Today, I am going about my day. I am going to allow my heart rate to go through my chest and beat so hard. I’m going to allow that lightheaded, blood pressure issue that I’m having to be there. I’m going to allow the dizziness to be there. I’m going to allow the raising thoughts to be there. I’m going to still show up in my yellow skirt. If I spin in a circle, it would be a full spinning circle. It would be so beautiful. And I’m going to keep my heart open. If you could see me right now, I’m not hunched up. My hands are soft, my cheeks are soft, my heart is open, my shoulders are dropped. I’m just here for it. I’m allowing it. Is it hard? Yes, it is painful as. Is it exhausting? Yes. Every night this week I’ve been going to bed at seven o’clock and just resting my body because I’m working really, really hard. And my body is exhausted because it’s pumping adrenaline all day long.

These are some ideas I want you to implement into your life if you can. And a lot of it, one thing, of course, I didn’t discuss because it’s just such a part of my practices, I’m also really gentle with myself. Like, “Yeah, Kim, this is rough.” I use the word “suffering.” You even heard me use it. “This is a lot of suffering for you right now, hun. You deserve to go to bed a little early and it’s okay if you don’t show up perfect and you might drop some balls. Yeah, that’s okay.” That’s the main point. 

Pots Awareness Month 

What I will say at the end here is please-- you’re probably hearing some of this and going, “Oh my gosh, maybe I have POTS.” I really want to make sure you know the difference. Given that it’s POTS Awareness Month, postural orthostatic tachycardic syndrome is not an anxiety disorder. It is a disorder of the autonomic nervous system. It does mean that when you stand up, there is changes in your heart rate and in your blood pressure that cause you to faint. Lots of people with POTS can’t stand up at all. So, I’m so grateful for the fact that I can stand up, even though it takes me two goes to fill up a drink bottle. I can stand up better than a lot of people who have postural orthostatic tachycardic syndrome. I can walk. I can exercise. I’ve been building up my exercise routine according to the POTS exercise program. 

Difference Between Anxiety And Pots 

It’s important for you to understand that just having these anxiety symptoms doesn’t mean you have POTS. If you are fainting and you are actually having a really difficult time with nausea and multiple different autonomic nervous system issues, well then definitely go see your doctor and share with them your symptoms. If they think that you are a candidate for maybe getting tested for POTS, the type of test you would need is called a tilt table test. It is usually administered by a cardiologist or a cardiologist nurse. It’s a horrible test, and if you have POTS, it will be very painful and very difficult. But basically, it’s where they put you on a table and then the table tilts up really fast, and then you’re connected to all these cardio nodes, I guess, all over your body and they’re got a blood pressure machine and some people even faint during the test. They raise you and then they drop you down flat and then they raise you and they drop you down flat and they’re monitoring whether there’s shifts in your heart rate and blood pressure. And that is the test that will get you diagnosed for POTS based on whether you meet criteria. It’s a very unpleasant test if you have POTS because it does induce fainting for a lot of people or a severe amount of nausea for a lot of people. But if you are concerned, you can reach out to your doctor and see if you meet the criteria to get that test. 

That’s it. I wanted to share with you what it’s like to have POTS and to share my ups and downs with having POTS. Also, one thing I will say, if you don’t mind and you want to stay with me just for a few more minutes, is having a chronic illness is also a very anxious experience. You never know whether you’re going to have a good day or a bad day. You never know what your symptoms are going to be. For me, I’ve actually been very blessed and the treatments have helped me a lot. For some people they don’t, but for some people, they can’t guarantee they can show up for work tomorrow. They can’t guarantee they can take their kids to the park. They just don’t know. It depends on the day and it depends on their body. So, there’s so much uncertainty with what your body will do and how your body will react. That in and of itself creates a lot of anxiety and uncertainty and it can be very, very depressing. 

For those of you who have severe POTS, they can’t play with their kids. They can’t stand up long enough to run in the park. It can be very, very debilitating. So, if you have a chronic illness and you have anxiety and depression, that doesn’t mean there’s something wrong with you. It actually means it’s a normal natural part of having a chronic illness. I wanted to really make sure I advocated for that because some people think if you have a medical problem, it’s just a medical problem. But often medical problems create mental health problems and we have to look at the whole human. Even though I’m an OCD and Anxiety Specialist, I’m still going to admit to you guys, it still creates anxiety for me. I handle it pretty well, but some days I don’t. Some days I’m very sad about it and have a lot of grief and a lot of anger and a lot of frustration around it and sometimes even jealousy. Just jealous. I wish I could A, B, and C.

I’ll tell you one story. There’s a person on social media and they constantly do their posts while they’re standing at a computer desk. Even just looking at her stand at a computer desk, she’s got one of those standing desks, I have so much envy because I’m like, “I could never ever do that.” Never ever do that unless somebody-- I don’t know. I didn’t even know how I would do it, but-- yeah, a lot of emotions show up. 

All right. So, that’s it for today. I wanted to share with you a whole little update on what happens when your chronic illness causes anxiety. I wanted to highlight that it’s Postural Orthostatic Tachycardic Syndrome Week or Awareness Week. Actually, I think it’s Awareness Month. I hopefully inspired you to lean into your fear and not give it all the power because you’re actually stronger than your anxiety. 

All right. Thank you so much for listening. I know it may have been a bit of a rambling episode, but hopefully, you took a few pieces away from it. I really, really appreciate you checking in. Please do go and leave a review. It is the best gift you can give me because it does allow me to then get trust of other people who are new coming to the podcast, and then we can help some more people. 

Take care and I will talk to you soon.

Oct 20, 2022

In This Episode:

  • The difference between Reassurance seeking vs. holding in emotions
  • Why Reassurance seeking OCD is problematic and keeps you stuch
  • What tools you can use to help you manage emotions with OCD

Links To Things I Talk About:

ERP School: https://www.cbtschool.com/erp-school-lp
https://kimberleyquinlan-lmft.com/32-reduce-reassurance-seeking-behaviorscompulsions/
Newsletter https://www.cbtschool.com/newsletter
Chatter Book:https://www.amazon.com/Chatter-Voice-Head-Matters-Harness/dp/0525575235

Episode Sponsor:This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.

Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

EPISODE TRANSCRIPTION

This is Your Anxiety Toolkit - Episode 306.

Welcome back, everybody. We are well and truly into OCD Awareness Week, and I have been so excited to be a part of some amazing awareness projects, being an advocate for the International OCD Foundation, doing a lot of social media on self-compassion this week. It’s been such a treat.

This week, I actually wanted to discuss a concept that I-- actually, I say this often these days, but I get asked this question a lot in some various forms by my clients, so I wanted to address this question that I got with you. This is actually a question from one of the people in ERP School, which is our online course for OCD. If you click the link here in the bio or you can go to CBTSchool.com, we have a course called ERP School where we teach, or I teach step by steps that I take with my patients on how to set up an ERP plan so that you can slowly face your fear and reduce your compulsions and take your life back from OCD.

306 Reassurance Versus Holding It In Your anxiety toolkit

Reassurance Vs Holding In Emotions

One of the members asked a question, and there’s a whole portal in there where you can ask questions to me directly, and they asked: “I have a question to you regarding reassurance seeking.” They said, “I’ve been trying to stop doing my compulsions and my go-to is reassurance seeking.” “What is the difference between Reassurance vs holding in emotions?”

Reassurance Seeking OCD

Reassurance seeking is a type of compulsion where you usually go to Google or you go to a loved one or another person and you ask for reassurance on your fear or your uncertainty. They go on to say, “One thing I do understand about is why it’s bad and how it keeps the cycle going.” So, they do understand that reassurance seeking OCD is a problem. They do understand how it keeps the OCD cycle going. We talk a lot in ERP School about this OCD cycle. It’s a huge component of the treatment. We have to first understand the cycle so that we can then know how to stop the cycle. And they go on to say, “I know that I have to learn to rely on myself to manage my anxiety and seeking reassurance makes me dependent on others for my relief, which can increase my anxiety when they’re not around. But I’ve always been told by friends and family that talking about things that are bothering you is healthy because that way you get it out as opposed to bottling it in. When I don’t seek reassurance, I worry that I’m bottling it in and that the only way to feel better is to let it out by talking to others. How do I join these two seemingly healthy ideas?”

This is such a core component of all the work that we do. And so, I really want to go deep into this with you here in just a sec. Now, before we move on, if you aren’t quite sure about reassurance seeking yet, you can go back and listen to a previous podcast we did, Number 32, which is called How to Reduce Reassurance Seeking Behaviors. It’s an amazing podcast episode that really goes deep into what is a reassurance compulsion. You can click that there. But let’s talk more about this specific question.

Before we do that, let’s quickly do the review of the week. This is from Isha.Isha and they said:

“An invaluable resource. I have read many books on anxiety and OCD, and yet I am continuously surprised to learn new things with this podcast. It is thought-provoking and brings forward new, helpful, and interesting content.”

She went on to say: “Kimberly, your 6 Part series on Mental Compulsions has truly been life-changing for me. Despite reading dozens of books on OCD and Anxiety, including yours, I was astounded to realize how many mental compulsions I actually have. The approaches to dealing with them, suggested by a few of the guests (thank you, Hershfield, Nicely, and Reid), have been nothing short of miraculous for me. Thank you for your hard work here! It is deeply appreciated!”

Again, you guys, if you go to CBT School and you sign up for our newsletter, you will be given a gift from me, which is a link where I have put all of those six-part mental compulsion audio files together and we’ve thrown in a whole bunch of PDFs that will help you really strategize your own way of managing mental compulsions. So, go sign up for the newsletter. If you go to CBTSchool.com, you’ll be able to get access to it there.

And then one more thing before we move on, let’s quickly do the “I did a hard thing” segment. It sounds like this person who asked the question is doing hard things too, but this one was so fun, I wanted to share it with you. Anonymous says:

“Having OCD has made wedding planning and the wedding process in general challenging for me. But this weekend, I made it to my bridal shower and I had the best time, even despite my OCD being along for the ride. I actually took the day as an opportunity to face the disorder head-on. I left feeling empowered as F***.”

Amazing, Anonymous. I’m so happy and congratulations on your bridal shower. I hope you had the most incredible time.

All right, so let’s look at this question. Let’s break it down. Okay. So, yes, this person has already shared they understand that reassurance-seeking keeps us in the OCD cycle, keeps the fear going strong, and only makes more problems. It makes problems for the person with OCD, but it also impacts the relationship. In fact, I would go as far as to say, those who engage in reassurance-seeking behaviors tend to have a bigger impact on their family members because they’re constantly going to their family members saying, “Would this happen? Could it happen? Do you think it could happen? What would happen?” And that person, because they’re not trained as a clinician, they don’t know how to respond. They haven’t been trained. Usually, they try many different ideas and it actually ends up making the person with OCD even more confused. And then that can create conflict in the relationship. We know this. We know that reassurance-seeking can be very, very problematic and we want to slowly reduce it.

It sounds like this person is doing amazing work, but they’ve got this dilemma in saying, “But I thought I was supposed to let things out.” Let’s take a look here.

Managing emotions with OCD

When you have an obsession, naturally, your instincts are, “How can I make this fear go away or this discomfort or feeling go away?” You’re going to want to do a compulsion. The goal of ERP is to reduce those compulsions. So, now what are you doing? So, you’re reducing the compulsion, you’re not trying to get reassurance, and now you’re handling a large degree of anxiety and stress. Yeah, that’s true. You will have to rise and fall in discomfort. Absolutely. We know that that’s a part of the work. Willingly, ride the wave of discomfort.

So, what I want to say to you here is you have some choices. You could ride that wave on your own. Let it go high, let it go low, let it go up and down, do what it wants, and you can practice actually allowing that discomfort and really building a resilience to that as you go. Similar to what Anonymous said in “I did a hard thing” is they left feeling empowered. When we do it on our own, we can actually feel incredibly empowered.

Now, that is one option. That doesn’t mean to say that when things are really hard, naturally, we do want connection. That’s what human beings want. So, sometimes we do want to go to our loved one and say, “I’m having a hard time.” But there’s a really big difference between going to a loved one and saying, “I’m having a hard time. Will this bad thing happen? Or do you think it will happen?” and saying to your partner, “I’m going through some stuff right now, would you sit with me?” One is very compulsive and one is not. But this is where OCD can be very, very tricky. Sometimes, just having a partner there forms reassurance. If your fear is like, “Well, what if I’m going to go harm someone?” keeping them in the room, even though you’re not talking, that can still serve as a reassurance because you’re like, “Okay, they’re here. They’ll stop me if I’m going to do something bad and I snap.” So, we want to keep an eye out for how reassurance seeking doesn’t have to be just verbal, it can be physical, it could be us just looking at them to see their face and go, “Okay, they look fine, they don’t look stressed. Okay, that gives me the reassurance that nothing bad is happening.” Catch the little nuances that can happen here because as we know, OCD can be very, very sneaky.

Again, we can use the option and it is healthy to go to your partner and say, “Hey, I’m really dealing with something. This is really hard. I’m riding a wave of discomfort.” But you’re doing that without getting any reassurance, without seeking any reassurance, without them reducing or removing your uncertainty or anxiety. So, you can do that. There are ways to do it. But the main thing to remember here is, are you doing this with urgency? Because that’s usually a very good sign that you’re doing something compulsive. Are you doing it in attempt to reduce or remove your discomfort?

If you’re able to be in conversation with them and discuss and seek support from them without seeking it in an urgent way or trying to reduce or remove your discomfort, well then that’s fine. But here is what I want you to consider just to start, is I am all for support. In fact, it is a human need to have support. But what I’m going to offer you is an idea, which is, when it comes to OCD, if you’re going to them for support because of this discomfort, there is a chance you’re still treating the fear like it’s important, and you will suffer. I get that. You’re going to have a lot of emotions. But if you have the emotions and you’re like, “Oh my God, I feel so bad, I just have these thoughts, or having this anxiety,” and you’re giving that too much attention by saying, “I need your support, I’m really, really suffering,” sometimes that in and of itself can actually reinforce the anxiety.

I guess you’re still probably thinking, well, what’s the balance? And there is no perfect answer. I’m sorry, I can’t give you a yes or a no. What I can say is, when it comes to OCD or anxiety, I personally am always going to encourage that you do it yourself as much as you can because that’s where you actually learn how much you can actually tolerate. Remember here, anxiety is always going to be sneaky and say in the back of your mind, “Kimberley, just in case, just so you know, my anxiety is high, but I can really turn it up and freak you out, so you better be careful. Do your best to avoid me.” That’s what anxiety says in some way or form. So, if we still treat ourselves as if we’re really fragile, we can actually reinforce that belief in that thought or intrusive thought.

So, I personally am always for myself going to say, “Okay, fear is here, how can I ride this one out 100% by myself?” and this is the key point to remember. Ask yourself in that moment, because you’re probably having some pretty strong reactions right now. Ask yourself in this moment if you are having a strong reaction, “What is my strong reaction to that?” Is it “it’s not fair”? Is it “that’s uncool, that’s too much to handle”? That just shows you where our work is and here is the key point. What is it that you want them to provide you? Is it warmth? Is it compassion? Is it relief from the shame you feel? Is it to know that they won’t leave you or they’re not judging you? What is it that they’re, this one particular person in that moment, what is it that they can provide you? And now, can you provide it for yourself? Or, is this thing you’re looking for even really that helpful?

So if you’re like, “Oh my gosh, I just need a safe place to land right now,” I beg for you to practice being the safe place to land. Not your partner, not your family, not your friends. You be that for you. You deserve to be the safe place to land.

If there’s a sneaky part of this where you’re like, “No, I just want them to tell me that I’m good and not a terrible human being,” well, that is in fact still reassurance. Yes, we’re all allowed to get that reassurance, but you have to ask yourself, is that reassurance a healthy reassurance or is it something keeping you stuck in the cycle? You get to choose. I’m not saying what’s right or wrong here because each person is different. If I’m with a patient, we will look at this and go, “Okay, let’s talk about why you want your partner to provide you support. What is it that the partner support provides you?” And we pull apart whether that support is in fact benefiting their long-term resilience and success in treatment or actually slowing them down. There’s nothing wrong with getting support at all, but is this an opportunity where you can show up and be your best person? Be the first person that’s standing there going, “I got you.”

Mindfulness & Self Compassion For Reassurance Seeking

Now here is the other piece of this, which is they’re talking about bottling it in. Let’s say you decide, “Kimberley, I’m on with this idea and I am going to commit to 30 days or seven days or one day or 10 minutes where I’m actually going to be the support for myself. I am going to practice my self-compassion skills, my mindfulness skills, my radical acceptance skills, and I’m going to be it for myself.” That doesn’t mean you’re technically bottling it in. Bottling it in is when you have the emotion and you shut it down and you refuse to let it pass through you and you hold it in and you pretend it’s not there and you’re faking your way through it. If sometimes you need to do that, that’s still fine. But this question is around saying that’s a problem.

Now here’s what I’m going to say. There’s really no scientific evidence to say that bottling things in is particularly bad, because how do we know what’s bottled in really? We can’t really measure what’s being bottled in, but we do know that if you don’t talk to people and you aren’t processing stuff that, yeah, it can create some problems. So, this again is, how can we be healthy in our expression and effective in our expression of what’s going on for us? Can you journal? For me, this might sound a little weird, but I am a little weird, is when I really have something I’ve got to get off my chest, I record an audio, I take a walk. I leave my kids and my husband and I take a walk and I record an audio of me just venting it out because, the truth is – this was particularly true during covid – me venting it out to my partner when he’s got his own stuff he’s working on, he’s also going through some things as well. It’s not helpful for me to dump it on him, so I would audio it into myself and listen back and listen for things that I could maybe work on.  So, there are ways.

Another way is to practice just feeling your feelings. That’s probably the most important thing I want to mention here and which is why I wanted to really report it, is feel your feelings instead of bottling them in. Now, we recently did an episode about this and how this idea of sitting with your emotions. Go back and listen to that because that’s important. When we talk about feeling your feelings, it doesn’t mean lashing out and having them all over the place and being really unskilled in how you manage them, and it also doesn’t mean having your feelings and staring at the wall and just being like, “Oh my God, I’m just so overwhelmed with this feeling, but I’m sitting with it.” It’s saying, while you go and engage with your life, you allow and embrace whatever emotions to come up. That’s not bottling it in. You saying them out loud is not what’s preventing you from bottling it in. They’re two completely different concepts.

Let’s finish up by really talking about what is a healthy way to ride a wave of discomfort instead of having reassurance-seeking compulsions play out. You could journal, you could feel your feelings while you engage with your life, and use skills that you have, mindfulness skills, skills from this podcast. Go all the way back to the beginning. We’ve got tons of good stuff at the beginning of the podcast episodes where you can actually mindfully experience your emotions while also engaging in life. You could do those.

You could also go and ask for support and say, “Hey, it’s a really hard time. I just did a really hard exposure. My anxiety is really high. I don’t want you to try and reduce or remove my anxiety, but your presence here is really wonderful. Thank you.”

You could be the one who shows up for you radically so hard. You could be like, “Hey Kimberley, what do I need? What do you need right now? How can I show up for you? Do you need my fear support? Do you need my nurturing support? Do you need my champion support? What do you need? And I’m here for you, sister.” That’s what I really want you to practice.

You could also find an OCD therapist who’s trained in ERP and say, “Hey, I’m working through some things. Can we talk about it in a way that doesn’t provide me reassurance?” Because you trust that they understand how to not provide reassurance. And that can be a really helpful way.

But there’s one thing I want you to remember here at the very end. The reason I’m saying it at the very end is I think this is probably one of the most groundbreaking things that I learned just this year, and this has changed my marriage. I’m not going to lie, it’s changed my marriage, which is this: At the beginning of this year, I read a book called Chatter. I will link it in the show notes. The book is-- let me pull it up really quick. The Voice in Our Head, Why It Matters, and How to Harness It by Ethan Kross. It is an amazing book.

One of the things that blew my mind was the research that venting actually increases a person’s distress and does not benefit them. What? That is the opposite of what I have been trained in my career. I was trained that venting is a really healthy thing. I know some of you may be like, “Well, duh, I’ve had issues with this in my past.” But the truth is, it really showed the data on why venting actually makes us feel worse. It actually has a negative impact and there’s no benefit to venting. So, I’m going to leave you to think about that because for me, when I read that, I can be-- I’m not going to lie, one of my not-so-great traits is I can be a little bit of a ventor. A ventor? Is that a thing? I can be a person who vents and unfortunately, my husband is the one who has to hear me process stuff. I’m a real process kind of person. What I realized when I learned this is, holy moly, I’ve been thinking that this is important and this keeps us connected, but the truth is, it doesn’t. It doesn’t impact me positively. It doesn’t impact him positively, even though he is the most kind, supportive man in the history of the world. This is actually not a good behavior and I got to stop it.

So, what I did is I called my best friend and I called my husband and I said, “From now on, I’m going to be much more mindful around venting. There will be times when I’m really struggling where I’m actually going to choose not to share about it in that moment. You might see that I’m spiraling on something.” I’m going to say, listen, now is not the time because I now understand the science that venting is not in fact beneficial. It just makes me feel worse and works me up more. So, I use all my tools and I double down and I ride the wave and I journal and I audio in and I ride the wave on my own.

So, here are some ideas you take and choose what you want, but that’s the main concepts I want you to consider. And there’s your answer, is this whole idea of holding it in is not the only option. You can, in a healthy way, ride your emotions and your wave of anxiety and you can do it in a way that actually is very effective that doesn’t require anybody else. However, if you require somebody, no problem. That’s wonderful. I hope that you have the most amazing, supportive people in your life and it’s all good.

So, that is it. I hope that is helpful for you guys. We did go around and around into all of the little cracks and crevices of this topic. If you’ve got any questions, you can always let me know. Please do leave a review because I hope this is helpful for you. I will see you next week. Next week, I’m actually doing a little bit of a personal episode, talking about a few shifts that I’ve had with my own chronic illness and how it’s impacted my own anxiety. All fun and games. Not really. No fun and games is what I should say.

All right, my loves, have a wonderful day. Please do remember it is a beautiful day to do really freaking hard things. You’re not alone because I’m doing the hard things and your friends are doing the hard things and all the people listening here, thousands and thousands of people are doing the hard things too.

Have a wonderful day, everybody.

Oct 13, 2022

In This Episode:

  • We talk about how the ton of your voice really matters when it comes to self-compassion practices
  • USING SELF-COMPASSION TO INCREASE MOTIVATION
  • USING SELF-COMPASSION TO BETTER APPRAISE EVENTS
  • How you can improve your self-compassion practices to include a warm nurturing voice.
  • How you can practice a kind coach voice in your daily life.

Links To Things I Talk About:

Self-Compassion Workbook for OCD: https://www.amazon.com/dp/168403776X/ref=cm_sw_em_r_mt_dp_2JG8H4VWFSBMBJVQ4AD8

ERP School: https://www.cbtschool.com/erp-school-lp

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.

Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

EPISODE TRANSCRIPTION

This is Your Anxiety Toolkit – Episode 305.

You guys, 305. That sounds like a lot of episodes to me. Oh my goodness. So exciting.

All right. I am really feeling so connected to the message that I have with you today. It has been an ongoing lesson I have learned in my life. It has been something that I have had to fine-tune in my own self-compassion practice. And I know I’ve spoken about this before, but I wanted to come on and do a quick reminder of why the tone of your voice matters more than anything. When I say the tone of your voice, I mean like how you speak to yourself, and that would also include how you speak to other people. That both. Both are very, very important. I’m sure you know this from experience of talking to other people. When your tone is a little off, it tends to create some problems. Am I right? I definitely have some stories to tell you on that one. But there have been so many times over the summer and going now into the fall where I have had to really keep reminding my patients and myself. And I’m going to tell you a couple of stories here about my family where this has gotten so, so important.

305 Why the Tone of Your Voice Really Matters Your anxiety toolkit

Why the tone of your voice matters more than anything? Because tone sets a scene for how things land. Here is an example. If I said to you-- let’s use last week’s example, we did a podcast on what does it actually mean to sit with your emotions. Now, as I talked about how frustrated I was about how-- sometimes we use this term and we don’t explain what it actually means. If the tone of my voice, as I said that, was like, “Oh my gosh, it’s so important that you use it in the right way,” I was saying those actual words. But if I’m using a tone that’s like, “You have to use it this way because you can’t use it this way!” that’s going to create inside a massive degree of anxiety and defensiveness and rejection from you guys. We can all agree. In fact, if you have read any of Dan Siegel’s work, he’s an amazing researcher, an amazing author – he talks about how the word “no” and how we say the word “no” can actually create a massive emotional approach or a response in people than if you were to say “yes” very kindly. Just a one-word difference.

What I want to talk about here with you is tone and why tone needs to be a major part of your recovery. Let me tell you a story. The other day, for those of you who don’t know, I have this beautiful, young daughter who just started middle school. Yeah, get ready for the ups and the downs. It’s been a total ride since she started. But my husband was actually at the end of the day reflecting to me in a very compassionate way and he was saying, “Isn’t it interesting how you can say to her, ‘Get your bags, let’s go,’ and that can land so different than ‘Get your bags, let’s go!’” Same words, different tone. Five words, same five words, but those five words and the tone that we use can shift their experience and the way we feel as we express it. We were talking about-- and he was actually giving me a little bit. I’m not going to lie, he was giving me a little bit of feedback that my tone could be a little calmer. In the morning, things are stressful. I know I have some work to do. I’m not going to lie. I was like, “Okay. Yeah, you’re so right.” Coincidentally, I was already going to record this podcast, because so much of how we talk to ourselves is about motivating. I’m motivating her to “Get your bags, let’s go, come on. We’re going to move to the next step. We’re going to be late for school.” And it’s about how do we motivate ourselves.

I’ve got some examples for you here and I want you to think about them and how they apply to you. These are personal examples, but I’m pretty certain you may or may not resonate with most of them. So, here we go.

Using Self-Compassion To Increase Motivation

The first one is how we motivate ourselves to get things done. So, what was shocking to me while I was in Australia, because things were much more calm and my workload was much less, is there were certain tasks I had to keep doing. Even though I was on vacation visiting with my family, I still saw my clients and I still had to respond to emails and so forth. But it was so interesting that when I sit to my desk, which I’m sitting at right now, I often use a tone, which is like, “You’ve got to write your email, get going!” Not that mean, but you hear what I’m saying. Maybe I’m going to be a little overdramatic in this today just for the sake of getting the message across. But like, “You’ve got to get your email done before you see your clients!” Whereas when I was in Australia, I had more space and I was like, “Okay, hun, you’ve got to get your emails done before you get and see your clients.” Same words, but the tone was so different. And so much of the motivating we deal with ourselves has a tone that is aggressive and unkind and bossy and anxiety-provoking and creates a defensive anxiety-driven experience. We all know when we are having anxiety, we actually then tend to build into that cycle even more.

So, I want you to think about, how do you motivate yourself? You might even want to pause this and sit down and be like, “What specifically do I say and where’s the tone that gets me in trouble?” What’s the tone that brings on emotions that create more suffering for us?

Another one, and this is true for a lot of my patients, this is where I pick up in them, is they know they have homework for therapy. And for those of you who are in therapy, usually, if you’re doing any kind of CBT, you get homework, so you have to get it done. And how you talk to yourself about that homework can determine whether you’re suffering or not. You could say, “I should get my homework done before I see my therapist!” or you could go, “Okay, I’m going to get my homework done before I see my therapist. When might I get that done?” Same topic, same motivation, same intention. The tone makes such a difference. Again, we’re talking about motivation.

Using Self-Compassion To Better Appraise Events

What about your appraisal of events? You could say, “That was really hard.” You’ve honored that you just did an exposure, let’s say, or you did your homework or you got your emails done, and then you go, “Wow, that was really hard.” That’s a lot different if you were really in a wrestle, “That was really hard! Urgh!” Because when we’re in that tone, we’re in, again, a resentful, angry tone. Not that there’s anything wrong with that. Again, there’s an important place for every tone. You’re allowed to be angry. You’re allowed to be frustrated. You’re allowed to be sad. You’re allowed to be resentful and all those things. I just want you to question your tone and be curious about your tone and ask, is it helpful? Is it effective for you?

An example of this is, we’re talking about motivation, if you’re in the last mile of a marathon, you might need to take on a tone that’s very coaching, very like, “Come on, you could do it!” And you’re like, “Ah, just get it done!”

I have a dear friend who is suffering with a lot of grief. She lost her father. When she’s playing her sports, she says, “I swear I can’t stop the whole time, and I use my anger to belt out the ball.” So, there is a great example. If it’s effective for you, go ahead and do it. But I want you to really question and be curious about your tone and really ask if it’s working for you. And then you have this great opportunity to start to play around with tones that work for you.

Same goes for when we talk about it’s a beautiful day to hard things. A client of mine once mentioned to me that this really, really made her mad. She hated this term. She was like, “This is very annoying. I don’t want to do hard things. I know I can do them, but I don’t want to do them.” Again, you can absolutely use any tone you want, but check in on the tone you’re using. Does it motivate you? Does it give you a sense of inspiration? Does it move you towards the behavior you’re using? Is it kind? Absolutely the most important. Does it feel safe to use that tone? These are just questions to think about.

One of the biggest ones is you made a mistake. You could say to yourself, “Okay, Kimberley, you made a mistake,” or you could say, “Kimberley, you made a mistake!” Same words, massive in different tone. Hugely different in the tone, same words. I keep saying same words. The tone is so much different and can really impact how much you suffer.

For me, the one that actually-- I got it last, but the one that actually blew my mind the most is the saying, “Keep going.” I could say to myself, “Keep going. Keep going, Kimberley. Keep going. You’ve got this. Keep going. Keep going.” And that’s this idea of just one more, you can do one more. But if I were to be saying, “Keep going! Just keep going!” Same words, totally different effect.

So, there’s some examples. You probably have dozens more, or the ones that are really, really different, but I really want, if you can implement, just checking in on your tone each day. You might find that you go leaps and bounds in your self-compassion practice. In fact, I found that the ones who mastered this idea, or not even mastered, just work towards having a kinder tone, tend to be people who end up embracing self-compassion and really reaping the benefits from it. Because again, this is why I’m saying, this is why the tone of your voice matters more than anything. It propels us towards healthier motivation. It propels us towards a bigger, wider self-compassion practice. It propels us away from having emotions that are brought on by this really mean tone, like more fear, shame, guilt, embarrassment, humiliation, irritability. When we use that tone, that really creates a really negative vibe for us. So, that is what I want you to take away. So, so important.

All right. Before we finish up, let’s quickly go over the “I did a hard thing” one. This is from Sienna and they said:

“In high school, I developed an eating disorder, and in college, I was diagnosed with anorexia nervosa. I’m currently one year out of college and weight restored, but eating is so difficult for me. I’m now in therapy for OCD, which my therapist and I realize, intersects with my eating disorder. It is very challenging for me to eat anything. I think I might be unhealthy and then continue to eating healthy foods that make me feel good. As a part of my ERP, I was assigned to drink kombucha once a day at lunch, and then continue eating healthy for the remainder of the day and to eat pizza once per week. These things scare me because of the pizza with my friends after a pool party, when I normally would have avoided the situation. I am so happy I was a part of my friend group in a way I previously couldn’t be and that I was able to face some of my fears.”

Sienna, this is so good. Oh, I love it. You’re doing such hard things. And I love how you’ve identified the specifics, like eating unhealthy, but then going back to your other. I think that is such a great-- you’ve identified what the trigger is. That is so, so important, and it’s such an important part of exposure therapy. We talk about this a lot in ERP School, which is our signature course for OCD, which is, as you plan your exposures, you really want to be clear on the obsessions that you’re going to be targeting. Because once you’ve identified a good obsession and what you want to target, then you can create some really great exposures and some really specific exposures for it. So, so good.

All right. Let’s finish up with the review of the week. It’s from Love Heart 2 and they went on to say:

“Kimberley knows her stuff. I discovered Kimberley’s podcast a few months ago, and I really love listening to her Aussie-American accent as I am an Aussie in the US myself.” How fun, Love Heart 2. That makes me feel so close with you. “So it feels like a little piece of home. Secondly, she’s very informed on OCD, which I have had for a long time and anxiety. When you get down on yourself as a result of a mental illness, you need someone like Kimberley in your ear, reminding you that you can do hard work and that you are worth it.”

Oh my goodness. Thank you so much for that review, Love Heart 2. If you haven’t left a review, please do so. It allows me to reach more people. When they see my podcast, it allows them to feel like they can trust what we’re saying. And that’s so important to me. The more people who feel that they can trust me, the more I can help them, and hopefully, I can bring just a little bit of joy into their day. So, thank you so much, Love Heart 2, and thank you so much, Sienna, for contributing to the “I did a hard thing” segment.

All right, my loves, I’m going to sign off. Please do remember that the tone of your voice matters. It really, really does. Have a wonderful day.

Oct 12, 2022

In This Episode:

  • We talk about how the ton of your voice really matters when it comes to self-compassion practices 
  • USING SELF-COMPASSION TO INCREASE MOTIVATION
  • USING SELF-COMPASSION TO BETTER APPRAISE EVENTS 
  • How you can improve your self-compassion practices to include a warm nurturing voice. 
  • How you can practice a kind coach voice in your daily life. 



Links To Things I Talk About:

Self-Compassion Workbook for OCD: https://www.amazon.com/dp/168403776X/ref=cm_sw_em_r_mt_dp_2JG8H4VWFSBMBJVQ4AD8

ERP School: https://www.cbtschool.com/erp-school-lp

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.

Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

EPISODE TRANSCRIPTION

This is Your Anxiety Toolkit – Episode 305. 

You guys, 305. That sounds like a lot of episodes to me. Oh my goodness. So exciting. 

All right. I am really feeling so connected to the message that I have with you today. It has been an ongoing lesson I have learned in my life. It has been something that I have had to fine-tune in my own self-compassion practice. And I know I’ve spoken about this before, but I wanted to come on and do a quick reminder of why the tone of your voice matters more than anything. When I say the tone of your voice, I mean like how you speak to yourself, and that would also include how you speak to other people. That both. Both are very, very important. I’m sure you know this from experience of talking to other people. When your tone is a little off, it tends to create some problems. Am I right? I definitely have some stories to tell you on that one. But there have been so many times over the summer and going now into the fall where I have had to really keep reminding my patients and myself. And I’m going to tell you a couple of stories here about my family where this has gotten so, so important. 

305 Why the Tone of Your Voice Really Matters Your anxiety toolkit

Why the tone of your voice matters more than anything? Because tone sets a scene for how things land. Here is an example. If I said to you-- let’s use last week’s example, we did a podcast on what does it actually mean to sit with your emotions. Now, as I talked about how frustrated I was about how-- sometimes we use this term and we don’t explain what it actually means. If the tone of my voice, as I said that, was like, “Oh my gosh, it’s so important that you use it in the right way,” I was saying those actual words. But if I’m using a tone that’s like, “You have to use it this way because you can’t use it this way!” that’s going to create inside a massive degree of anxiety and defensiveness and rejection from you guys. We can all agree. In fact, if you have read any of Dan Siegel’s work, he’s an amazing researcher, an amazing author – he talks about how the word “no” and how we say the word “no” can actually create a massive emotional approach or a response in people than if you were to say “yes” very kindly. Just a one-word difference. 

What I want to talk about here with you is tone and why tone needs to be a major part of your recovery. Let me tell you a story. The other day, for those of you who don’t know, I have this beautiful, young daughter who just started middle school. Yeah, get ready for the ups and the downs. It’s been a total ride since she started. But my husband was actually at the end of the day reflecting to me in a very compassionate way and he was saying, “Isn’t it interesting how you can say to her, ‘Get your bags, let’s go,’ and that can land so different than ‘Get your bags, let’s go!’” Same words, different tone. Five words, same five words, but those five words and the tone that we use can shift their experience and the way we feel as we express it. We were talking about-- and he was actually giving me a little bit. I’m not going to lie, he was giving me a little bit of feedback that my tone could be a little calmer. In the morning, things are stressful. I know I have some work to do. I’m not going to lie. I was like, “Okay. Yeah, you’re so right.” Coincidentally, I was already going to record this podcast, because so much of how we talk to ourselves is about motivating. I’m motivating her to “Get your bags, let’s go, come on. We’re going to move to the next step. We’re going to be late for school.” And it’s about how do we motivate ourselves.

I’ve got some examples for you here and I want you to think about them and how they apply to you. These are personal examples, but I’m pretty certain you may or may not resonate with most of them. So, here we go. 

Using Self-Compassion To Increase Motivation

The first one is how we motivate ourselves to get things done. So, what was shocking to me while I was in Australia, because things were much more calm and my workload was much less, is there were certain tasks I had to keep doing. Even though I was on vacation visiting with my family, I still saw my clients and I still had to respond to emails and so forth. But it was so interesting that when I sit to my desk, which I’m sitting at right now, I often use a tone, which is like, “You’ve got to write your email, get going!” Not that mean, but you hear what I’m saying. Maybe I’m going to be a little overdramatic in this today just for the sake of getting the message across. But like, “You’ve got to get your email done before you see your clients!” Whereas when I was in Australia, I had more space and I was like, “Okay, hun, you’ve got to get your emails done before you get and see your clients.” Same words, but the tone was so different. And so much of the motivating we deal with ourselves has a tone that is aggressive and unkind and bossy and anxiety-provoking and creates a defensive anxiety-driven experience. We all know when we are having anxiety, we actually then tend to build into that cycle even more. 

So, I want you to think about, how do you motivate yourself? You might even want to pause this and sit down and be like, “What specifically do I say and where’s the tone that gets me in trouble?” What’s the tone that brings on emotions that create more suffering for us?

Another one, and this is true for a lot of my patients, this is where I pick up in them, is they know they have homework for therapy. And for those of you who are in therapy, usually, if you’re doing any kind of CBT, you get homework, so you have to get it done. And how you talk to yourself about that homework can determine whether you’re suffering or not. You could say, “I should get my homework done before I see my therapist!” or you could go, “Okay, I’m going to get my homework done before I see my therapist. When might I get that done?” Same topic, same motivation, same intention. The tone makes such a difference. Again, we’re talking about motivation. 

Using Self-Compassion To Better Appraise Events

What about your appraisal of events? You could say, “That was really hard.” You’ve honored that you just did an exposure, let’s say, or you did your homework or you got your emails done, and then you go, “Wow, that was really hard.” That’s a lot different if you were really in a wrestle, “That was really hard! Urgh!” Because when we’re in that tone, we’re in, again, a resentful, angry tone. Not that there’s anything wrong with that. Again, there’s an important place for every tone. You’re allowed to be angry. You’re allowed to be frustrated. You’re allowed to be sad. You’re allowed to be resentful and all those things. I just want you to question your tone and be curious about your tone and ask, is it helpful? Is it effective for you?

An example of this is, we’re talking about motivation, if you’re in the last mile of a marathon, you might need to take on a tone that’s very coaching, very like, “Come on, you could do it!” And you’re like, “Ah, just get it done!” 

I have a dear friend who is suffering with a lot of grief. She lost her father. When she’s playing her sports, she says, “I swear I can’t stop the whole time, and I use my anger to belt out the ball.” So, there is a great example. If it’s effective for you, go ahead and do it. But I want you to really question and be curious about your tone and really ask if it’s working for you. And then you have this great opportunity to start to play around with tones that work for you. 

Same goes for when we talk about it’s a beautiful day to hard things. A client of mine once mentioned to me that this really, really made her mad. She hated this term. She was like, “This is very annoying. I don’t want to do hard things. I know I can do them, but I don’t want to do them.” Again, you can absolutely use any tone you want, but check in on the tone you’re using. Does it motivate you? Does it give you a sense of inspiration? Does it move you towards the behavior you’re using? Is it kind? Absolutely the most important. Does it feel safe to use that tone? These are just questions to think about. 

One of the biggest ones is you made a mistake. You could say to yourself, “Okay, Kimberley, you made a mistake,” or you could say, “Kimberley, you made a mistake!” Same words, massive in different tone. Hugely different in the tone, same words. I keep saying same words. The tone is so much different and can really impact how much you suffer. 

For me, the one that actually-- I got it last, but the one that actually blew my mind the most is the saying, “Keep going.” I could say to myself, “Keep going. Keep going, Kimberley. Keep going. You’ve got this. Keep going. Keep going.” And that’s this idea of just one more, you can do one more. But if I were to be saying, “Keep going! Just keep going!” Same words, totally different effect. 

So, there’s some examples. You probably have dozens more, or the ones that are really, really different, but I really want, if you can implement, just checking in on your tone each day. You might find that you go leaps and bounds in your self-compassion practice. In fact, I found that the ones who mastered this idea, or not even mastered, just work towards having a kinder tone, tend to be people who end up embracing self-compassion and really reaping the benefits from it. Because again, this is why I’m saying, this is why the tone of your voice matters more than anything. It propels us towards healthier motivation. It propels us towards a bigger, wider self-compassion practice. It propels us away from having emotions that are brought on by this really mean tone, like more fear, shame, guilt, embarrassment, humiliation, irritability. When we use that tone, that really creates a really negative vibe for us. So, that is what I want you to take away. So, so important. 

All right. Before we finish up, let’s quickly go over the “I did a hard thing” one. This is from Sienna and they said:

“In high school, I developed an eating disorder, and in college, I was diagnosed with anorexia nervosa. I’m currently one year out of college and weight restored, but eating is so difficult for me. I’m now in therapy for OCD, which my therapist and I realize, intersects with my eating disorder. It is very challenging for me to eat anything. I think I might be unhealthy and then continue to eating healthy foods that make me feel good. As a part of my ERP, I was assigned to drink kombucha once a day at lunch, and then continue eating healthy for the remainder of the day and to eat pizza once per week. These things scare me because of the pizza with my friends after a pool party, when I normally would have avoided the situation. I am so happy I was a part of my friend group in a way I previously couldn’t be and that I was able to face some of my fears.”

Sienna, this is so good. Oh, I love it. You’re doing such hard things. And I love how you’ve identified the specifics, like eating unhealthy, but then going back to your other. I think that is such a great-- you’ve identified what the trigger is. That is so, so important, and it’s such an important part of exposure therapy. We talk about this a lot in ERP School, which is our signature course for OCD, which is, as you plan your exposures, you really want to be clear on the obsessions that you’re going to be targeting. Because once you’ve identified a good obsession and what you want to target, then you can create some really great exposures and some really specific exposures for it. So, so good. 

All right. Let’s finish up with the review of the week. It’s from Love Heart 2 and they went on to say:

“Kimberley knows her stuff. I discovered Kimberley’s podcast a few months ago, and I really love listening to her Aussie-American accent as I am an Aussie in the US myself.” How fun, Love Heart 2. That makes me feel so close with you. “So it feels like a little piece of home. Secondly, she’s very informed on OCD, which I have had for a long time and anxiety. When you get down on yourself as a result of a mental illness, you need someone like Kimberley in your ear, reminding you that you can do hard work and that you are worth it.”

Oh my goodness. Thank you so much for that review, Love Heart 2. If you haven’t left a review, please do so. It allows me to reach more people. When they see my podcast, it allows them to feel like they can trust what we’re saying. And that’s so important to me. The more people who feel that they can trust me, the more I can help them, and hopefully, I can bring just a little bit of joy into their day. So, thank you so much, Love Heart 2, and thank you so much, Sienna, for contributing to the “I did a hard thing” segment. 

All right, my loves, I’m going to sign off. Please do remember that the tone of your voice matters. It really, really does. Have a wonderful day.

Sep 30, 2022

SUMMARY: 

Today we have Natasha Daniels, an OCD specialist, talking all about how to help children and teens with OCD and phobias.  In this conversation, we talk all about how to motivate our children and teens to manage their OCD, phobias, and anxiety using Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and other treatments such as self-compassion, mindfulness, and ACT. We also address what OCD treatment for children entails and what changes need to be made in OCD treatment for teens. In this episode, Natasha and Kimberley share their experiences of parenting children with phobias and OCD.  



In This Episode:

  • What does sitting with emotions mean? 
  • How to sit with difficult feelings 
  • How to sit with your sadness 
  • How to sit with uncomfortable feelings, 
  • Sit with the feelings 

Links To Things I Talk About:

ERP School: https://www.cbtschool.com/erp-school-lp

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.

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EPISODE TRANSCRIPTION

This is Your Anxiety Toolkit - Episode 304. 

Welcome back, everybody. It’s a delight to have you here with me today. 

Oh, I’ve got so much I want to talk to you about and this is actually coming from an emotion of frustration, this episode, which every time I check in and I begin a podcast, I try to come from a place of fun. And am I feeling calm? And am I feeling completely connected to you, the listener? But today, just for fun, I’m coming to you from a place of frustration. And the frustration, promise, this is not going to be a vent episode – it’s actually a frustration in that I caught an error that I’ve made, and I think a lot of clinicians are making. And it’s not an error in that it’s bad or wrong or problematic. It’s just that I caught something in my own practice, and I was like, “Oh, hold up, we have to talk about this.”

So, saddle in, get your cup of tea, settle in, because we’re going to have to have a conversation about wording. It might be really nuanced and I want you to take what’s helpful and leave the rest. I want you to think about it with an open, curious mind, and decide what’s best for you. 

So, before we get into the show, as always, let’s start with the “I did a hard thing.” Let’s do it. This one is actually from someone that says-- the handle name is GottaCatchEmAll, and they said:

“Thank you so much for your recent series on mental compulsions. Your podcast is truly a godsend and I’ve been listening nonstop ever since my friend shared it with me last month.”

Now, for those of you who don’t know, the mental compulsion series was a six-part series that we created here on the podcast. It had so many amazing clinicians on. If you want access to that series, you can go back and listen to previous podcasts. Or, if you sign up for our newsletter, you’ll go to CBTSchool.com/newsletter. I will actually send you an amazing webpage, just one link where all the episodes are there, all the PDFs are there. It’s so pretty. I have to say it is so pretty, and it’s like a one-stop shop for that series. So, go over to the newsletter, CBTSchool.com/newsletter. Sign up for the newsletter. You’ll get an email from me every week. But on the front end, you will receive that link. I’m so proud of it. I love it. So, I digress, sorry.

They went on to say: “I suffer from a plethora of different anxieties, OCD, scrupulosity, hoarding, body dysmorphia, perfectionism. So, basically a bunch of normal human things, right? Exactly. The other day, I told my therapist that dealing with all of these issues felt like playing a game of whack-a-mole in my head, except that instead of the typical game, the mole would pop up and then a zebra and a giraffe, and so on, in a quick succession throughout the course of the day. While sobbing, I told my therapist that I didn’t want to have a zoo in my head and I didn’t know how to treat so many issues simultaneously. Imagine my surprise when I heard a recent episode called Whack-a-mole Obsessions, it was a relief to discover that I wasn’t alone and weird or broken as I thought. I realized, instead of trying to resist or whack the zoo in my head, I could approach my anxieties and compulsions like they were different Pokemons that I could catch and train and carry around with me while I live the rest of my best life. Thank you, Kimberley, for putting on such an incredible content and for helping me and so many others navigate this difficult thing.”

That is so good. Look at you working through that whack-a-mole ongoing struggle with different thoughts, different disorders, and so forth. I think so many of us resonate with this and you are definitely doing hard things. So, so, so cool. 

All right. Real quick, before we get to the frustration that we’re all hanging out for, let’s just quickly do the review of the week. This one is a shorty from Inventedcharm, and they said:

“It is a mental pick me up. I love listening when I need a mental pick me up. Kimberley’s voice is soothing, and she offers great tools for self-compassion and interviews other experts in the field of mental health.”

So, thank you, Inventedcharm, and thank you, GottaCatchEmAll.

304 What Does It Mean to Sit With Emotions Your anxiety toolkit

Okay. So, here we go. I’m going to tell you a story of why I’m landing here on this episode with you today. So, once I got back from Australia, a lot of you know I spent five and a half weeks in Australia over the summer with my children. It was so beautiful. I can’t tell you how full my heart was when I returned. I was energized. I was the happiest I’ve ever been. And you know where this is going. Yeah, we do. I crashed big time. I just went through so much sadness. I missed my family. I was angry. I had so much grief. I was feeling, actually, if I’m going to be completely honest, quite a lot of resent towards even my husband, who I love and is such a wonderful human. But I was observing resent show up because I was like, “I don’t understand. I just want to be with my family and why can’t I have all the things I want?” So, all these emotions started showing up. 

WHAT DOES IT MEAN TO SIT WITH EMOTIONS? 

My therapist – of course, I talked with a therapist – was saying, “Everything, Kimberley, that you’re saying makes complete sense. Why don’t you practice sitting with your emotions?” And of course, I was like, “Yeah, that makes sense. I have given that advice myself.” And so, off I went right onto the roller coaster, or we could say the whack-a-mole to talk about the “I did the hard thing” segment, the whack-a-mole of emotions with the agenda of not numbing them like I often do. Sometimes when I work, I engage in these numbing behaviors where I just numb all of everything out by working. It’s something that I’ve overused as a coping skill, is when I work. So, I’m not doing that anymore. I’m not using any other problematic safety behaviors.

I caught all these problems. So, it’s like, “I think really all you’ve got left to do is just sit with your emotions.” So, I went, “Okay, let’s do it. There’s no solution. There’s nothing I can do about this. Let’s just sit with it.” And I started to play with this idea of, okay, let’s talk about what does it mean to sit with your emotions. Now, this is where, again, I’m going to identify, I’ve given this advice and I’m going to say, I don’t think I’m going to give that advice anymore. Or if I do give it, and for any reason you don’t catch me doing this, you can always bring it to my attention, but I’m going to do my best, is I’m going to add another sentence to the whole “sit with your emotions” concept, because let’s say often you guys have heard me say, “Sit with anxiety, sit with your anxiety.” And that’s helpful because we know that doing compulsions with anxiety is a problem. If you resist or avoid or try and remove your anxiety, it’s going to create more problems. But where that gets in the way is it doesn’t mean you just sit there and do nothing but stare at the wall and just let the anxiety beat you into a pummel. No. I think that the mistake I’ll make, and I’m going to be completely transparent, I think the mistake I make is I’m assuming you guys know what I mean by that, and I’m assuming that you know, I mean, don’t just sit there and stare at the wall. 

There were a couple of days where I was so overwhelmed with emotion that I did just sit there and be like, “Okay, I’m allowing this. I have to allow it. I’m sitting here. I’m allowing it. Oh man, this is hard,” until I was like, “Wait a second. This is not helpful. Just sitting here and letting it pummel me, that’s not the whole picture. There has to be tools and skills associated with it.” That’s where I’m talking about in regards to anxiety. It’s a great concept, but what do we actually mean when we say, “Sit with your emotions”? We mean, allow it, particularly when we’re talking about fear. We’re saying, don’t interfere with it. Don’t engage with it. Don’t wrestle with it. Don’t stir it up. And we’re also saying, don’t run away from it. We don’t thought suppress. So important. 

So, I totally believe that sitting with emotions is an important concept, but we must, and I am sorry if I haven’t mentioned this and I haven’t gone a full explanation, we then must engage back into life. We must engage back into the things that we value. We must engage, even if we don’t like it. Sometimes you have to do the dishes. Sometimes you have to get out of bed. And sometimes we have to allow emotions, embrace emotions, bring on emotions in order to get up and do those things. But that’s just anxiety. 

HOW TO SIT WITH DIFFICULT EMOTIONS? 

Now, let’s talk about which emotions should you sit with and which ones shouldn’t you? Now, number one, there is no bad emotion. There’s no such thing as a bad emotion, a negative emotion, a problematic emotion. They’re all just neutral. And that’s huge to know. But as I was sitting in the chair of the client instead of being the therapist, and I was really going, “Okay, I’m not going to engage in these behaviors. I’m going to instead just allow them and sit with them,” I realized sometimes asking yourself to sit with an emotion, particularly ones like guilt and shame, that too isn’t completely helpful. We need to put an extra sentence on the end of that as well. So, we can say, “Sit with your emotion of shame, but also be aware of the stories it’s telling you, not taking it as a fact.” Because as I was noticing, so much shame showed up for myself in this specific situation. I was thinking, wait, if I told my client to sit with shame, but I hadn’t taught them the skill of diffusing from shame or observing the story of shame, they’re going to have shame and be like, “Oh yeah, it’s true. I am bad. I’m just going to sit with the fact that I’m bad.” So, no, no, no, no, no. That’s not what we mean, again, by sitting with emotions. We’re not saying we’re going to sit with them and accept them as fact. 

Let’s talk about sitting with sadness and grief because, boy oh boy, did I have sadness and grief. And it would come in waves that punch me in the face. I’d be like-- and again, I want to validate grief. Doesn’t matter, it’s not just losing a human body. Nobody passed away. That’s definitely grief. But I was handling grief and loss of like, “Oh, I missed my family. I wish I was there. I wish I lived there. I wish I could just snap my fingers and be there. I wish the world was different. I wish COVID didn’t happen.” All these things. So, I just was getting these waves of sadness. And it was important as I was “sitting with sadness.” That’s okay. We want to do that. We want to allow it. We don’t want to interfere with it. We don’t want to run away from it. We want to embrace it. But we don’t want to thicken it with hopelessness as we sit there. We don’t want to thicken it with like, “Yeah, bad things are going to keep happening and there’s not hope.” That will only create more problems. 

HOW TO SIT WITH SADNESS? 

So, when we say “sit with your emotions,” particularly the one of sadness, we actually want to sit in sadness again with non-judgment, with curiosity, with awareness of other things. And when I did that, when I sat with my emotions and was curious and open, I noticed like LA’s got a beautiful, beautiful scene. The vibe is really cool. I love my house. I really do love my house. I love the fact that my house is surrounded by trees. I love my family. And I allowed me to be open to sadness and other parts of my life here. So, again, I’m bringing this up of just like in that moment of doing the action, I was thinking, oh my goodness, we need to make sure we expand our description of what it means to sit with your emotions. 

If you need more step by step, in my book, The Self-Compassion Workbook for OCD, if you have OCD, I actually have a full chapter on managing strong emotions. And in that book, I actually did, I believe, a good degree of explanation. But I wanted to get on here and set the-- what do you say? Set you straight? That’s not right. Set the story straight. I don’t really know what that saying is, forgive me. But I wanted to be really clear and actually correct if I’ve ever said this term, “sit with your emotions.” It’s not a bad term. I actually almost called this episode “Why I’ll never say sit with your emotions again.” But the truth is, I won’t. I can’t hold that as true. So, I changed it to “What does it really mean to sit with your emotions,” and how can we add additional context to that statement so that it doesn’t mean you’re just indulging the emotion and all of the trash that some emotions can leave behind. And what I mean by trash, I’m not judging, it is like, with sadness comes hopelessness sometimes. So, we want to be careful not to engage with that and infuse too much with that. With shame comes a story that you’re bad, that you’re wrong, that you don’t have any worth. We don’t want to indulge or engage in that while we allow and experience the emotion of shame. 

HOW TO SIT WITH ANGER? 

Anger was another one. I went through these crazy waves of anger and talking with a therapist like, “Okay, you’re having your anger.” Of course, don’t lash out or say me unkind things, or catch yourself if you’re starting to feel highly dysregulated. And then just sit with your emotions. And I thought, wow, again, there’s that saying. But if I’m angry and I’m sitting with it, I could easily percolate on some pretty hateful thoughts. I could be sitting with and ruminating with that emotion. And that is not what we mean when we say “sit with your emotions.”

So, I really wanted to just drop into this. If I were to sum up this whole episode, the thing I want you to think about the most is, there is no right way to manage an emotion and there is no right or wrong emotion. There is no-- and I talk with my patients all the time about this. There is no playbook on how this is supposed to go. The metaphor I often use is, it’s like any sport. Some of you may know, I’m learning tennis. I actually pretty suck at it, but that’s a whole nother story. The whole thing I’m learning is, and the reason that I suck, and I don’t say that in a judgmental way, I actually think it’s hilarious, is it’s all about being super flexible. So, I’m standing and my knees are bent and I’m holding my racket and I’m going left to right, left to right on my feet, and I’m getting ready for this constantly changing direction of a ball. And I have to stay really flexible. So, if the ball goes all the way to the right, I have to move my legs so I can move to the right. And then if next time it goes to the left, I have to be ready to make that maneuver. 

HOW TO SIT WITH OTHER DIFFICULT EMOTIONS

Same goes with emotions. Your emotions are going to flip flop and go from left to right and north to west, and it’s going to give you a run for your money. And we have to be able to adjust the strategy depending on what’s coming to us. And that’s true of emotions. In simple, we’re always going to observe it, allow it, acknowledge it. In some points, we have to be curious instead of being closed and judgmental. These are skills you can use with all of them. But as I’ve gone through some of the more difficult emotions today, sometimes we have to catch the themes that percolate and loop us into it when “sitting with emotions.”

So, that’s the main thing I want to talk to you. Again, I’ll tell you, as I-- I was actually driving to the dentist and I called a very dear friend of mine, and I just said, “I actually just had a major epiphany. We can’t keep saying ‘sit with your emotions’ as clinicians. We have to make sure we add context to what that looks like, and it means not just sitting still and doing nothing, except focusing on the emotion.”

So, if this resonates with you, I hope it does. It was such an important thing I wanted to talk with you about again. Does it mean it’s wrong? Absolutely not. If you’re a clinician or you hear this, or you’ve probably even heard it from me – if you’ve heard it, it doesn’t mean they’ve done anything wrong. I just want you to understand what it actually means when they say that and to add those extra sentences at the end and give context to like-- again, don’t interfere with them. Don’t run away from them. Allow them. Also, don’t calculate and ruminate on them either. 

Sending you so much love. As always, this is really hard work. So, please do remember, it is a beautiful day to do these hard things. And I will add, for any of you who are writing out waves of emotion right now, I salute you. I have such deep respect for you because it’s no easy feat to choose an emotion, to choose to tolerate it and interrupt behaviors that are problematic and allow emotions to rise and fall. That is some pretty impressive work you’re doing. And I just want to give you a massive shout out because it’s not fun. It’s hard. It’s not easy. It’s skillful work. It takes some stamina to do it, and it’s exhausting. And so, if you’re doing even 10% of this work, I applaud you. 

All right, my friends, I will see you next week. Have a wonderful, wonderful week. Again, please do go to CBTSchool.com/newsletter if you want access to that mental compulsions worksheet. And I’ll be seeing you in a week.

Sep 23, 2022

SUMMARY: 

In this episode, I addressed a question that was asked of me by a loyal follower.  They asked, “What do I do if the present moment totally sucks? Like, what if I have a migraine , nausea , chills , pain?  Any suggestions ?!”

This is such a great question and one we probably have all asked ourselves or our therapist at some point.  



Links To Things I Talk About:

ERP School: https://www.cbtschool.com/erp-school-lp

Episode Sponsor:
This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.

Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

Ep. 303 What if the present moment totally sucks?

EPISODE TRANSCRIPTION

This is Your Anxiety Toolkit - Episode 303.

Welcome back, everybody. Thank you from the bottom of my heart for being here with me. Thank you for listening. Thank you for supporting me. I know how valuable your time is, and I know there are so many people that you could spend your time with, especially out on the podcast field. So, I am so, so grateful to have you here with me. Really, really, really I am. I hope that you find these episodes incredibly helpful. My hope is to give you bite-size tools so that you can get on with your life and live your best life. I hope this podcast is everything that you wanted to learn. 

This week’s episode, I am totally, totally amped for. The reason being is, it was actually a response to a previous podcast where we talked about being present. Somebody had written back because they subscribe to my newsletter. If you haven’t subscribed to my newsletter, please do so. I will leave a link in the show notes, or you can go over to CBTSchool.com and sign up there. They had responded and said, “But Kimberley, what do I do if the present moment totally sucks?” And they went on to say, “I have a migraine or nausea or chills or pains.” And they said, “What are your suggestions?” I figured, this is probably the question you all have for me. I come on, I share with you tools. And then you guys are probably always going to have a question and this is a really common one. 

WHAT TO DO IF THE PRESENT MOMENT TOTALLY SUCKS

Today, I want to talk about what to do when the present moment totally sucks. Before we do that, let’s first do the “I did a hard thing” segment. This one is from Rachel and they said:

“My thoughts get the best of me. I recently started teaching and I needed to stay long after the students go home. And I decided it just needs to be a busy time to distract me. I use your book to help me with any meditations and I just let my thoughts come and go. It was scary the first time, but now I’m used to it.”

Thank you so much, Rachel. I’m so grateful my book can be of assistance. I think you’re doing some really, really hard work there. So, congratulations on that. 

And then last of all, before we get into the bulk of the episode, let’s first share a review of the week and this is from Meldevs and they said:

“I am so thankful to have found this podcast! Kimberley is such a compassionate, warm, honest, and insightful person for those struggling with anxiety disorders as I do. I have learned more listening to her than I have in my years of therapy. The way that she presents each and every podcast episode so that I feel challenged and understood. Thank you, thank you, thank you for being there for people struggling with anxiety!”

Thank you, Meldevs. That is such a beautiful review, really. That brings me so much joy and I really, really appreciate all your reviews on the podcast, because it helps me to reach more and more people. Meldevs and Rachel, thank you so much for being a part of my community. Let’s get into the episode. 

What do we do when the present moment totally sucks? Let’s break it down. 

When we talk about being present, one of the biggest mistakes we make, and I talk with my patients about this all the time, is we assume that being present means everything feels great. I think we have in our mind that being present is when we are most mindful, when we are most at peace, when we’re most compassionate. And I’ll tell you honestly, that has not been my experience. Oh no.

HOW TO BE PRESENT WHEN ANXIOUS

Being present, the art of being present, the practice of being present in your most mindful sense has never meant being comfortable in my experience, especially as my experience with it as a clinician, especially as my experience of having my own mental illnesses and my own medical illnesses. No, it’s not that. Most of the time, when we need to be present are the times when things totally suck, when we’re in a great deal of distress. Because otherwise, if you’re not in distress, usually, you don’t have to be as present because often you naturally are. 

So, let’s just remember that our brains, when we are uncomfortable, is wired to focus on that discomfort. That’s how we’ve survived all these years. And it’s going to focus on the pain because it is trying to send a message to you to get the pain to go away. But when we have something where the pain won’t go away, have it be migraine, like you said, nausea, chills, discomfort could be also anxiety or intrusive thoughts because we all know we can’t stop those. When we experience those, yes, naturally, you’re going to want to run away from it. But as a part of this team and as part of this community, you guys know and hopefully, I’ve taught you that running away from discomfort only makes it worse. Resisting the pain we feel and the suffering we feel only makes it worse and increases our suffering. So, what do we do? Friends, we settle in. I’ll give you a personal example of when I actually recently had COVID. 

Some people bless your hearts. And also, I’m really still very mad at these people, but still, bless your hearts. I wish this was the case for everybody. But some people have very few symptoms when it comes to having COVID. I am not one of those people. When I have COVID and when I got COVID, I get bone pain. It is like the deepest pain in my bones. It goes right to the center of my bones and it is so painful. My daughter and my husband both had COVID as well. My daughter came in. And I, when I’m in this state where my bones hurt this bad, I’ve had it several times in my life. She said, “Mama, you’re tensing up. Your face is all squished.” I was holding my muscles tight. And thank goodness, because I was in so much pain that I actually needed somebody outside of my body to tell me this was happening because I just was so entrenched in the pain I was feeling that she said, “Mama, you’re all tense.” Thank goodness I’ve taught her that tensing up around pain actually makes it worse. Her and I have had many conversations around this. 

STEP ONE: VALIDATE

And so, I naturally was able to go, “Oh, okay, Kimberley, let’s pause.” Number one, validate. “Hun, you’re in a lot of pain.” You could even say, “This present moment totally sucks.” Or you could say, “Wow, I’m observing that you’re really uncomfortable right now.” So, if that’s you and your present moment really sucks, I’m strongly encouraging you first validating. The alternative would be you go, “It shouldn’t be this way.” But the truth is, it is this way. So, don’t go down the road of fighting it. 

STEP TWO: STOP RESISTING THE PRESENT MOMENT

The second piece is then check for where you are resisting the present moment and how much it sucks. Now I’m going to keep saying the word “sucks” really passionately because it does sometimes really suck, like really suck. And so, when it really sucks, it’s almost like the more it sucks, the more we have to soften around how much it sucks. If you have a migraine, the worse it is, the more you need to soften your brow and close your eyes and soften the environment that you’re in. The more you feel nausea, the more you feel your stomach nodding up. And some of you may feel that just by me mentioning it. The more you feel that, the more you need to soften around that physically by relaxing your muscles and softening your thoughts around it. Meaning now is not the time to beat yourself up for it. Now is not the time. Some people are going, “Yeah, but it’s my fault. I have nausea because I drank too much,” or “I ate too much,” or whatever it may be. Now is not the time to go through that. Now, the facts are, the present moment totally sucks. And so, let’s be gentle around it because our resistance makes it worse. 

If you were like me and you have the chills and you’ve got literal, like feels like every bone in your body is broken, now is not the time to fight that and tense your muscles. Now is the time to soften. If you’re having a full-blown panic attack, first acknowledge, “Okay, I’m noticing I’m having a panic attack.” And then soften around it physically and cognitively in your thoughts. Don’t resist it. 

Now, that being said, let me bring a very important concept to the table. And this actually just came up this morning. So, as many of you know, I have my online business, which is CBTSchool.com, and then I also have a private practice where we see clients. Because I can’t see all the clients that come to me, I have 10 amazing therapists who work for me and who I have trained and who I supervise every single week. We have a meeting every Monday, and we talk about cases. One of my staff was telling me today that one of her patients took what she said literally, which actually is pretty common. She was explaining to her patients that when you have anxiety and panic or discomfort, you sit in the discomfort or sit with the discomfort, or be with the discomfort. And this patient and client took it literally, which is fair. We have to be really descriptive and give lots of steps and explanations. And so, while they were feeling this discomfort, they literally sat in a chair and just stared and suffered. So, if I’ve ever said, sit with your discomfort, please don’t take it literally.

And so, what I want to remember here and what I remind you of, I should say, is once we’ve acknowledged and we stop the resistance to it, we must then reengage in something we value. So, let’s use me as an example. I had COVID. I literally felt like every bone in my body was broken. That doesn’t mean I’m going to get up and go for a run. It doesn’t mean I’m going to get up and see patients because I’m actually in pain. I wasn’t able to. But what I can do is instead of putting my attention on how much it’s painful, I’m going to put my attention onto something else. And it could be as little or as minute as the sound of the leaves rustling outside, the sound of music, the, the smell of the cough medicine I had taken, the taste of the cough medicine I had taken, the touch of the blanket. So, you just get really in touch with that. And then you catch how your mind then keeps offering you thoughts that make you want to reengage back with the pain. 

Now, again, I’ll give you another example. Most of you know, I have a chronic illness. I have postural orthostatic tachycardic syndrome. I am dizzy almost all the time. It’s under control now. I don’t faint nearly as much as I used to. But dizziness is actually a very normal part of my existence, particularly when I’m standing up. And so, my job is to allow it and then to catch when my brain starts to say, “It shouldn’t be this way. This isn’t fair. It’s not good. This is bad. It could be better. Your life could be better.” My brain offers me those thoughts and I choose not to entertain them.

Now, I’m not perfect at this, and this is something I’ve been practicing for a long time, so please be gentle with yourself. My job and your job, when the present moment totally sucks, is to be an observer to our brain. And of course, as I said, at the beginning, it’s going to present to us all the problems and why this shouldn’t be the problem. And you just say, “Thank you for showing up. I totally get what you’re saying, brain. Thank you for being there for me, but I’m going to keep directing my attention to whatever it is in front of me.” 

If you have anxiety and you’re having panic, you’re having high levels of anxiety, I’m going to say to you, ask yourself the question, what can I do or what would I be doing if anxiety wasn’t here right now? And go do those things. Don’t just sit in the discomfort. Only go engage back with life. Do the most that you can with your life WHILE you have anxiety.

Now, let’s also address one other main issue. In no way am I saying to dump toxic positivity on yourself here. In no way am I saying things like, “Oh, you should be happy. The leaves are so beautiful.” Again, like I was saying to you, no, absolutely not. That is not what we’re talking about. 

If you feel sad about this, if you feel down about it, if you feel a little discouraged or irritable, that’s okay. We can also be mindful and acknowledge, “Yeah, I’m feeling really frustrated with how I feel so terrible.” We’re not here when we’re mindful. We’re not here to say it shouldn’t be this way and just be happy about it. No, like I said to you, in my experience being present, my most mindful is actually when things totally suck. And I don’t try and change it that often. In fact, I just try to allow it, bring it in and then add other valuable things into my life. 

Can it be positive? Absolutely, if you want it to be. But if the suffering you’re experiencing is depression or hopelessness or grief or panic, we don’t need to throw a bunch of positivity on there unless it’s really helpful to you. All I’m here trying to do is get you to not fight how painful it is because that usually makes it more painful. And also, we don’t want to thicken the pot of it by going, “You’re right. It does suck. It’s not fair,” and all those things. That can actually often-- we have research to show that that rumination actually makes our suffering worse.

I know I said that was the last thing, but I have one more important thing to say, which is, please, please practice nonjudgment. If you’re going to be mindful, you have to practice nonjudgment. You can’t have mindfulness without nonjudgment. I have a whole episode on that. The whole point here with nonjudgment is, when we say this moment totally sucks, it’s actually a judgment. And I don’t want to take that from you. I don’t want to take that from you. It’s okay. You’re allowed to acknowledge it. But we also want to catch that how sometimes when we’re judgmental, this is good and this is bad, we actually train our brains to send out more anxiety hormones when we have that experience the next time, especially when we tell ourselves it sucks and it shouldn’t be there. So, keep that in mind. 

Anytime I’m going through something difficult, and this is very true of my work that I did around dizziness, with my POTS, is I had to take all the judgment out of it to reduce my suffering around my dizziness. Because the more I judged it, the more I felt completely hopeless and depressed about the situation. The more I felt like, oh, I just don’t have an answer, there is no answer. 

Again, I didn’t say, “Wow, I love dizziness. It’s so positive and wonderful.” I just said, it’s a sensation. I’m going to be gentle. I’m going to acknowledge it and allow it and lean into it, but not give it too much attention. And it’s neither good nor bad. And that was a conscious, intentional decision. Again, be careful that it doesn’t become toxic in that you’re pushing too much positivity on yourself, but again, it’s a balance.

So, there it is. That is what I would encourage you to do when the present moment totally sucks. And as I said, the present moment, especially when you’re suffering, it will totally suck sometimes. But that doesn’t mean you’re going in the wrong direction. It doesn’t mean it’s going to stay that way forever. There’s another piece to catch. 

I am just in love with you guys. I really am. What an amazing, amazing community. Please, if you want to be part of my community, you can go over to Instagram @YourAnxietyToolkit. You can listen to this podcast and go right back to the beginning and listen to the beginning ones. You can go over to Facebook. We actually have a private Facebook group called CBT School Campus. You’re welcome to come and join us there. Thank you. Just love you, love you, love you. 

Have a wonderful day and I’ll talk to you next week.

Sep 16, 2022

In This Episode:

  • What is the difference between a Panic Attack and an Anxiety attack? 
  • What is the prevalence of Panic Disorder? 
  • Are anxiety attacks dangerous? 
  • Are Panic Attacks dangerous? 
  • How does anxiety affect the body? 
  • What anxiety does to your body when expereincing a panic attack?  
  • What is the best treatment for panic disorder

Links To Things I Talk About:

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. 

Spread the love! Everyone needs tools for anxiety...

If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

302 Are Panic Attacks Dangerous Your anxiety toolkit

This is Your Anxiety Toolkit - Episode 302. 

Welcome back, everybody. Today, we are talking about a question I get asked very commonly: Are panic attacks dangerous?

Now I get this question a lot from clients who are just starting treatment. However, I will say I do get this question a lot on social media. People like doing the last-minute panic DM. What’s happened usually is they’ve experienced a panic attack or an anxiety attack, and then they have the thought, what if this panic attack is dangerous? What if this panic attack creates some illness in my body or is unhealthy for my body or unhealthy for my baby, if they’re pregnant. And so, from there, now they’re having anxiety about their anxiety and, as you guys know, then anxiety just takes off from there. So, I wanted to address this with you first. I’ve got a series of questions that I want to go through here with you. I will be looking a little bit at my notes because I wanted to make sure I got everything today. 

Before we do that, let’s first do the “I did a hard thing” segment. This is a segment where you guys write into me and tell me the hard things that you’ve been doing – facing your fears, staring your fear in the face, or maybe it’s something not related to fear. It’s just something that you’ve been going through. So, go ahead and submit those to me anytime you would like. Let’s go over. This one is amazing. It says:

“Honestly, Kimberley, you have changed my life in the last two weeks. I was in such a low place and coming across your podcast gave me so much power. I even faced my fear of heights last weekend and I went bungee jumping.” Love it. “That was frightening. And as I was falling, I screamed F-U-C-K,” but they said it in real life, excuse the language. “And I just thought, if I can do this, which is honestly terrifying, I can stop my mental rituals that are just so hard and scary.”

This message is so good and it’s exactly the epitome of the work that we do and you do, which is when we face our fear, we realize how strong we actually are. And then we go on to face our fears again, which helps us to feel even more strong and courageous, which makes us do even harder things. And from there, our life turns away from getting smaller and smaller to getting bigger and bigger. So, I love this. 

All right, let’s get to the show. So, we really want to pull apart, are panic attacks dangerous? But what’s interesting about this is, often when we talk about panic attacks, people start to talk about what’s called an anxiety attack. So, let’s first just pause and really talk about what is what. So, what is the difference between a panic attack and an anxiety attack? Let’s just go through that first so that we all know we’re talking about the same thing. 

What Is The Difference Between A Panic Attack And An Anxiety Attack? 

A panic attack or panic disorder is a disorder that is in the DSM, which is the Diagnostic Statistical Manual of Mental Disorders. That’s what we use to diagnose people. It usually involves a sudden onset of panic. It can last for minutes, sometimes longer than that or hours. For some people who are really struggling, it usually involves shaking or trembling or it may be heat flashing, hot flashes through your body. Some people experience a sense of detachment from their body. They may experience dizziness, sweating, heart pounding, maybe depersonalization and derealization, which we have episodes on if you want to go back and listen, trembling, sweating, weakness, feeling of extreme terror. Some people have numbness in their hands and feet, again, which is why they then question, is this dangerous? You can imagine, if you’re having any of these symptoms, it’s terrifying. It’s terrifying. But once we really get educated about what that is, then we can actually work with it.

Now, as I said, when it comes to having panic disorder, you need to have had at least one of those panic attacks. And then that’s usually followed by one month or more of the person then fearing having another panic attack. And that can actually lead to some people having panic disorder with agoraphobia. Some have it with agoraphobia, which is where you feel like you can’t leave the house, and some do not. 

So then the other part of this question is, what about an anxiety attack? Now, here’s the thing to remember. I asked quite a few clinicians, what do you think the difference between these is? And I actually got a ton of different answers, which I know isn’t super helpful for you guys, but some just basically said, “I don’t consider them any different at all.” Others said, yes, there is a difference in that an anxiety attack isn’t usually a disorder of its own, and it’s usually in relation to an actual threat. So, let’s say, panic disorder is very sudden, it’s often irrational, but not always. And so, it’s coming on very strong out of nowhere. However, an anxiety attack often gradually builds. It can last for several months. It can cause restlessness, sleep issues, fatigue, muscle, tension, and irritability. That though can all show up with panic disorder as well, but the main key thing that a lot of clinicians, and I’ve done some research online, is some people believe that it’s about what the trigger is. So, with an anxiety attack, if the trigger is an actual threat, like there is a dog running towards you and it’s going to bite you, or there is an actual threat in your society, a gun or weather issues, extreme weather, that that would be a trigger that would cause an anxiety attack and that’s how you would separate them. 

Now, for the sake of today, I’m going to use them interchangeably. Whether it’s from a current stressor in your life that is actually a danger or whether it’s panic disorder in that it’s just sudden and out of the blue or related to a specific fear or phobia you have, I’m going to talk about them as if they’re the same, given that their symptoms are often the same. And really, what I want to look at today is about whether these symptoms are dangerous or not.

What Is The Prevalence Of Panic Disorder?   

Before we move on, let me quickly give you a little prevalence here, because I just wanted to normalize if you’re having panic, and I’m going to read directly here. The National Institute of Mental Health reports that approximately 2.7% of the adult population in the United States experience panic disorder each year. That’s pretty big. They went on to say, approximately 44.8% of those individuals experience a panic disorder that is classified as severe. 

Now, I think that’s actually really interesting because anyone who’s had a panic attack is going to say it’s severe because a panic attack is 10 out of 10. So, I think that that’s actually-- I’m surprised. I would be surprised if it’s actually not way more than that. But what I’m guessing they’re also talking about here is the degree in which it impacts their functioning. Because a panic attack in and of itself, and we’ll talk about this here in a second, isn’t a problem. What can get in the way is it starts to make your life very, very small and can impact your functioning, your ability to have conversations, interact with people, go to work, go to school, sleep, eat, and so forth. So, really important that you get those points. 

Are Anxiety Attacks And Panic Attacks Dangerous? 

But then we want to move over to: Are these anxiety and panic attacks dangerous? So, let’s talk about that. Let’s look at those symptoms – chest pain, hot flashes, dizziness, pounding heart. Often when we experience those symptoms, we would make the assumption that something is terribly wrong with our body and we better get to the hospital pretty quick. Chest pain – what do you see often on advertisements and so forth?

You can imagine, when you have those sensations, it makes complete sense that your brain is going to set off the alarm. I do encourage you all, if you’ve had these symptoms, go and see a doctor, explain to them what happened and have them do a check on you so that you are really clear that what you’re experiencing is a panic disorder or a panic attack or an anxiety attack. We all know the common TV show where they get rushed to the hospital and they’re having a heart attack. And then the doctor, in a comedic way, says, “You’re having a panic attack. It’s common.” It is true. Statistics show it. I think this is correct that the most admissions into an ER is panic attacks. Isn’t that so fascinating? So, it makes sense that people are afraid.

But once you’ve had that clearance and I do encourage you to get clearance and just speak with your doctor always about that stuff, and if they’ve defined like you’re having a panic attack, then your job is actually, when you have those sensations, to not respond to them as if they are threats. If you respond to them as if they’re threats, you’re going to create more panic. We’ve got a whole ton of other episodes out about panic, so I’m not going to talk about too much there. But what I want to talk about is, are they dangerous? And the same goes for anxiety attacks. 

What I’m going to tell you once and once only is, no, they’re not dangerous. Our body can withstand all of these symptoms many, many times. Lots of people who’ve been through very difficult times or had panic disorder can go on to live wonderful, healthy lives. But here is where I want to maybe address the elephant in the room. If you don’t follow me already, there is a chance you found this podcast because you saw the title and you were like, “Oh yes, I want to know if they’re dangerous.” And once you listen, you may actually feel compelled to come back and listen to this episode again and again to reassure yourself that they’re not. If that is the case, I’m going to strongly encourage you not to keep listening after you’ve listened to the first time. 

Let me give you some information about that. When I see a patient for the first time, I do a lot of psychoeducation. I share with them, these are common sensations, this is normal if you’ve got panic. If you have these sensations, we’re going to treat them like we would treat panic symptoms. I would educate them if they’re concerned about the dangerousness. But then I would say to them, after today, we’re actually not going to keep revisiting these questions because what will happen is, the more you tend to these questions, the more you actually be fueling your panic disorder. Anytime you respond in a way that’s urgent and need to reduce your anxiety or your uncertainty, the chances are, you’re making the anxiety worse. So, I want to give you permission to go and see your doctor. I want you to get permission to share all of the details that you’re experiencing. Then I want you to give yourself permission to have your panic attacks without trying to solve whether they’re dangerous or not. Not tending to all of this, because the truth is, number one, nobody knows, number two, even I don’t know for certain, for every different person, and number three, the more you try and solve it, the more that you’re putting too much attention on this question that can actually keep you stuck in the cycle.

How Does Anxiety Affect The Body?  

Once we look at that, and that’s probably as far as I would go with my patients as well in terms of addressing that, often people have questions like, well, then what’s the impact of anxiety on my body? How does anxiety affect my body? How does panic impact my body? And again, I want to tread very gently because you deserve to have some psychoeducation about that, but we also want to be careful that we don’t spend too much time, again, tending to fears about what anxiety is doing to our body. Remember here, a lot of anxiety disorders is ultimately the fear of fear itself. Even though the content might be on something specific, it’s usually our resistance to having fear and experiencing fear and doing so without response or reaction. 

So, does it impact the body? Yes and no. Meaning it does tend to make us increase sleep struggles. It makes it difficult to eat. There are many impacts that it can have on the body. But again, catch – the question, how does it impact my body – if that’s actually you saying, is this dangerous? 

Think of it this way. When we ask questions and we pose questions to our mind, the words we choose and the emphasis we ask them can actually create more anxiety. If we say, “That’s so dangerous, we shouldn’t be doing that,” it’s true of anything. When you label anything as good and bad, you actually increase your resistance and your wrestle with it. If you say something is bad, you’re going to have anxiety about it next time. 

And so, what we want to look at here is, yes, it does impact our body in terms of it’s exhausting and it creates struggles without regular functioning. So then what I would encourage you to do, instead of tending to back and forward on, is this anxiety good or bad for my body, what does it do to my body, does this anxiety impact my body in a healthy way – instead, put your attention on, what will help me overcome this anxiety in the long term? Anytime we ask for the short term, we’re always going to do something that’s a safety behavior or a compulsion, an avoidant behavior, a reassurance-seeking behavior. So, just keep asking yourself, what will help me in the long term overcome this fear? And often that involves not ruminating about whether it will be dangerous or not because when we ruminate, we get stuck. And when we get stuck, it makes the fears look bigger. 

Isn’t it interesting, and I’m going to call myself out here, in that in my attempt to address the question, are panic attacks dangerous, my advice or my encouragement to you is to practice not trying to solve that question, i not giving attention to that question. Yes, you can get basic psychoeducation or you can go to your doctor and get a checkup, but anything beyond there, you’re always, and hear me if you can, if you can take one thing away from today’s episode, is really remember that anxiety is about willingness to tolerate discomfort and it’s about your willingness to be uncertain, especially if you have disorders like panic disorder, OCD, phobia, social anxiety, generalized anxiety. It’s almost always going to be, can I be uncertain? How can I be more uncertain? How can I practice riding the waves of uncertainty? And that’s very much the case with this specific question. 

So, I hope that is helpful. Again, catch your urgency to listen to this over and over and do your best to acknowledge the thought that you’re having, treat it like a thought and not a fact, and then move on into the things that actually bring you value into your life because that is what recovery looks like. 

Thank you so much for being here with me today. I am honored to have this special time with you. I hope that was helpful. Do please remember, it is a beautiful day to do hard things because this work is hard, but it is done in effort to really serve and nurture the future you. Even though it’s hard right now, we’re really tending to the wellness of the future you when we take on these really difficult concepts

Have a wonderful day, everybody, and I will see you next week.

Sep 9, 2022

This is Your Anxiety Toolkit - Episode 301.

Managing OCD Relapse (with Jazzmin Johnson) 

Welcome back, everybody. I am covered in goosebumps. I literally, as we speak, just finished the recording of this episode. I wanted to come on and do the intro right away just because I’m so moved by this week’s guest.



This week, we had Jazzmin Johnson. She’s a mental health advocate and she came on to talk about something she felt really, really passionate about, which is relapse, particularly related to relapse with anxiety disorders, even more particular and specific is with OCD. And she brought to the conversation the same struggles that I have seen my patients have over and over with relapse and how hard we can be on ourselves when we relapse and how difficult it can be to pull ourselves out of relapse. It’s a topic that I haven’t touched on nearly enough. And so, I’m just so grateful for her to come on and share her story and the steps she took to overcome any kind of relapse that she was experiencing, and identifying the difference between a lapse and a relapse I thought was really profound.

I’m just so excited to share this episode with you. I actually had scheduled it to be out much later and I’m like, “No, no, no, we just have to get this out. This is so, so important.” So, I’m so thrilled. I’m not even going to do an “I did a hard thing” because this whole episode is Jazzmin explaining to us how to do hard things. So, I’m again impressed with how she’s handled it. So, let’s get straight to the show.

I love you guys. I hope you can squeeze every ounce of goodness out of this episode. I think the main real message we took away is it’s a beautiful day to do hard things. So, enjoy the show.

301 Managing OCD Relapse with Jazzmin Johnson Your anxiety toolkit

Kimberley: Welcome, everybody. I am so excited to have a special guest on the show that I’ve actually been wanting. We’ve been talking back and forth. I’m so excited to have Jazzmin Johnson on today. Thank you for being here, Jazzmin.

Jazzmin: Thank you so much. I’m absolutely honored and really, really excited to chat.

Can OCD Relapse? 

Kimberley: Yeah. So, let’s dive in. We are going to talk about relapse, which is a topic I think you brought to my attention. I have not covered barely at all. So, let’s dive into that. But before we do that, can you give us a little background and fill us in up to where we’re at with relapse? Can OCD Relapse? 

Jazzmin: Yeah, absolutely. So, my name is Jazzmin. I’m 28 years old. I was diagnosed with OCD when I was just freshly 23. So, it’s been a while. Looking back on my life, I’ve had OCD for a very long time, long before I was 23. So, definitely fun to look back on your life and the moments and say, “Oh, that was an interesting behavior and no one really caught that.”

My story is I always love to tell it, but it started off with a really simple night of not sleeping, something that we think we’ve all experienced. And up until that point, I had assumed I was this rock-solid girl who was tough and I skateboarded on the weekends and just knew that nothing could touch me. And I remember having a hard night of sleep one night and my heart was beating really fast and I just felt really panicky. It was such a bizarre feeling for me. I remember at the time reaching out to my sister who also struggles with anxiety and OCD as well, and I just said, “Hey, have you ever dealt with this weird heart palpitation thing at night and you can’t relax?” And she just sent me a text in all caps and was like, “Yes, that’s anxiety.” And I think it was just this bonding moment where we were just like, “Oh, okay, I guess I’m like you like. Let’s do this.”

But with that I think came a lot of fear too, because as someone who was assuming I was this rock-solid gal, who was tough and never stressed about anything, to have that identity switch that happened when I was told that I might have anxiety. As all of us know, listen to this, anxiety is a terrible feeling and it’s even harder when it really sticks around for a long time. I remember feeling like my body was buzzing all the time and I remember trying to explain it to my boyfriend and he was just like, “That’s really strange.” And I’m like, “You don’t understand. My whole body feels like it’s vibrating all the time and I just couldn’t sleep at night.” And so, I ended up reaching out to my mom and she helped me find a therapist, which I’m really grateful that my family is really pro helping people with mental health disorders. So, they knew exactly how to help me.

So, I popped in with a therapist and was just like, “I don’t have anxiety. Why am I having anxiety? What’s going on?” And she just asked me if there were things that made me anxious. And I just remember telling her, “No, there’s no reason. My life is really good. I really enjoy where I’m at and I love my job and I love my boyfriend and I love my life. So, why am I feeling this way?” And she just said, “Well, have you talked to anybody about it?” And I remember telling her, “Yeah, my mom and my sister, and they’ve told me the things that make them anxious.” And so, now when I think about those things, I plan to be anxious in those scenarios too. And I just told her I was having a hard time figuring out what was causing this anxiety. And she just said-- I will remember these words forever because they started everything for me. But she said, “Maybe you just need to find yourself in all of this.”

And so, I went home and was just like, “What does that even mean, how do you find yourself?” I was so lost. And at the time, I was thinking, okay, I’m 23 years old. What do I need to do? Do I need to eat, pray, love, and go to Italy and dump my boyfriend? And then that’s when that thought popped in my head. And I thought, what if I need to leave my boyfriend in order to not feel anxious anymore? And of course, that terrified me at the time. I’d been with my boyfriend for five years. We were high school sweethearts. I knew in my bones I would marry him one day. And the idea that the only way out of how I was feeling was to lose something that I really valued was just life-shattering. And so, I just spent so much time thinking to myself, no, that can’t be it.

But OCD is the doubting disorder and I just hated this idea that what if that was the key to it all and it was something I didn’t want to do. And so, I fought it and I probably struggled with that thought for another three or four months. I spent every day thinking about it the first time I woke up in the morning. And it got to a point where my body and my brain was trying really hard to convince me to leave because it wanted this relief from this anxiety. So, I was almost trying to convince myself and arguing with my mind on why I need to leave. And it would jump from maybe I didn’t like the way he looked or he has a mustache this week and I don’t like mustaches, so maybe I need to leave. Or his jokes are really bad. I can’t be with someone whose jokes are bad. I mean, it’s almost comical to the point where the things that my brain was trying to do to get me out of this scenario that felt like anxiety was ruling at all.

I remember going to therapy every week, and my therapist just said, “You’ve been talking about this for a long time and it sounds like you might be struggling with some obsessive thinking, and it might be OCD.” And that crushed me because at the time, I thought of OCD as flicking light, switches on and off, and I did not know what it was and that it could look different. So, I just got really scared and she just said, “Nope, we’re going to work through this. You’re going to be fine.”

And so, we did my first exposure in that appointment and it was absolutely horrible and it was so hard, but we sat down and we mapped out what my life would look like for the next five years if I chose to leave. My life looked great. I was like, “I would move. I would go to LA and become a fashion designer,” whatever I was into at the time. And she was like, “You’d probably be okay. So, why is this so scary to you?” And I just told her, “I just don’t like this feeling of losing agency over my choices and feeling like anxiety was making those choices for me.” And that really made me spiral into a bit of a depression and just really struggled with feeling like I could do anything really.

My therapist and I, we talked and I was prescribed antidepressant, which I owe my life to because that antidepressant gave me the strength to stand up against OCD for the first time in my life. And so, I started and I started just diving into the OCD community and listening to stories online, reading about it. Not just reading about people that were struggling, but people that had made it out or had worked through it and were doing really well. I just loved listening to specifically Stuart Ralph’s The OCD Stories podcast and your podcast really. I just loved hearing people’s stories about OCD, because I would listen to it on my way to and from work on my hour-long commute. And I would always smile when I was listening to these people’s poor traumatic stories, just because I could hear how different our obsessions were, yet we were all doing the same thing. There were so many similarities that I heard and I just felt such a sense of community and belonging. And so, I just really dove into that and was like, “Hey, let’s talk about this. Now, why isn’t anyone talking about relationship, anxiety, and relationship OCD?”

I reached out to Stuart Ralph and he let me post a little blurb on his website about what I was going through and that started my advocacy journey. And so, now I just float through life and deal with what it throws at me. And of course, I struggle at times. OCD will always stick around, but I try really hard to always have all of my social media channels open for people that just want to talk. And I find that’s just such a good space to have for people when they just need someone to understand. So, that’s a brief, little rundown of my life with OCD so far. 

Kimberley: I had goosebumps for quite a bit of that. It’s just like it gives me the chills in the best way and that you’ve gotten through so many bumps and windy corners and stuff. Then we come to here now. So, you’ve got this progression, this windy story and you arrive. And obviously, you’re doing pretty well. Tell me about this idea of relapse and what that means to you.

How to Deal with OCD Relapse

Jazzmin: Yeah. So, I look at lapses and relapses, in my opinion, a little differently. So, of course, in my journey, I had a few lapses. There were things that life happens and stress trauma happens. A few instances, I was really unfortunate to be in a space at my work where someone chose to take their life. And I was not at work, but I walked in about two minutes after it happened, because it happened at my work. I didn’t see anything, but just the feelings of the people around me just was really traumatic. And so, my OCD latched onto that for a while and that sense of safety that I felt and the fear of being in another instance or something else that would be traumatic. And of course, there’s been other moments in my life where really wild, crazy things have happened. And my OCD does always find something to latch onto for a short while. But usually, I’m able to notice a behavior and feel like, “Oh, that feels familiar. Uh-oh, I think I might be stuck again,” and then I can usually spot it. But this last spring, I had a bit of a relapse and I call it a relapse more than a lapse because it looped back into my old themes that I had worked through a lot. And it lasted for a really long time. And I really had a hard time finding that kind of pathway out. I couldn’t really find where on the cycle, the OCD cycle I was to where I could see where to get out.

And so, at the time, I looked at relapses as failure and I think that’s one thing I really wanted to talk about. But I imagined that since I had come so far in my recovery, that when OCD shows its face again, I would know that it was OCD. I would see it and I’d be ready and I’d have my warrior gear on and I’d fight it and I’d carry on with my life. I think this last spring, just with the chaos that happened in my life, I learned that that’s not always the case. And sometimes it takes a little bit longer. But also, I think it always unlocks new layers to your recovery journey and healing that I think I needed to learn. So, I’m really grateful that it happened, which is so funny. I wish I could tell myself that four months ago and I was really in the thick of it, but yeah, I’m really grateful that I had that experience.

OCD Relapse Story…or is that not the right wording? 

Kimberley: Why do you think-- because I really resonate with what you’re saying and I think I’ve had, even in the last couple of weeks, some clients who’ve come back to treatment after doing really well with ERP and therapy. Can you tell us your OCD relapse story? Why do you think we consider it a failure to relapse? Where did that come from, do you think?

Jazzmin: I think for me, I hear a lot about in the OCD community of just this idea of being fighters and warriors and we’re going into this battle. And once you’ve won the battle once, you feel not untouchable, but you just have that upper hand. And I think with every new theme that it throws at you, which it always will, it’s something new and it might take longer to recognize that, oh, this is the same thing. But for me, it felt like I was just losing a game, losing a battle, and that I knew how to fight. And I always would use this metaphor with my therapist that I felt like I had my toolkit with all of the things I had learned over the years, all of the exposures I can do and scripts and stuff I can write, but it felt like it was in a toolbox that was locked. Like I had to find the key before I could get to that toolbox. And when you’re feeling so terrible, you’re frantically searching to find that specific key. And I just found myself fumbling.

And so, I think that idea of failure comes from just knowing better too. I felt like I knew better. I know what OCD looks like. I know this cycle like the back of my hand, yet, somehow it sneaks into my life again. I don’t realize it until either it’s too late and I’ve been doing compulsions for months maybe. And that is always a real letdown just in your personal self-esteem, and your idea of where you were in recovery can sometimes shift. And that’s scary because you think you’re through it or you’re better than that or that you know better. And then to find out maybe you were wrong, it’s really hard to sit with.

Kimberley: Yeah. It’s an interesting reframe, isn’t it? We think of being a fighter and getting through it as if you won the battle and the battle is over. It can be a massive dent to your self-esteem would you say? Or tell me a little bit about, did it shift your perspective of yourself being a fighter for a while or were you able to be like, “No, no, this is the work”? How was that feel?

Jazzmin: I think it’s a little different for me because at the time, I really considered myself an advocate. And I felt as an advocate, I guide other people and I help them through these things. And I remember a really specific moment with my husband after we had just met my baby niece for the first time. And the entire time we were visiting her, I was having intrusive thoughts probably every second and it was jumping themes. It was harm and then pedophilia and then harm again and harming myself. And I remember getting in the car with him as we left and just crying. And he just was like, “What’s going on? Talk to me.” And I just told him, “I’m so tired. I know what this is. I had those thoughts. I knew they were OCD. I knew the moment they showed their face, because why would I ever want to do that to my beautiful baby niece?” And yet, they still made me anxious. And I had made the story to myself that if an intrusive thought made me anxious, I’d already lost. So, my reaction to it was the first thing I could control. And when you get thrown a new theme, it knocks you down because you’ve never seen it before and it’s scary.

I just remember crying to him and just explaining, “I am so frustrated with myself because I know what this is. I know what I’m doing and I can almost step outside of myself and see the cycle. I can draw it on a piece of paper. In fact, I did that often, and yet I couldn’t stop.” It was just a lot of disappointment in myself.

I think as an advocate, you feel like you should know better and I helped people through this. In fact, there were times when I was in that relapse that people reached out to me for help. And I strapped on my booth and helped them and walked, talked them through it all and found them therapists and then was like, “Why can’t I do that for myself? Why am I so good at helping others and not giving myself the tools that I know are sitting right in front of me?”

Kimberley: Yeah. I thought it was really interesting. You said like you were mad at yourself, or maybe I didn’t use that word correctly, for having anxiety about your thoughts. Oh my God, when did the expectations get so high? What are your thoughts about that?

Jazzmin: I have no idea. It’s so funny too, because when I look back on the themes that I’ve always had, it’s always been around feeling anxiety. I have a fear of feeling anxiety. And that first thing I had was, maybe this will get rid of my anxiety. So, all of my obsessions were what’s the key to get rid of it. In fact, I often have an intrusive thought to this day that maybe my anxiety disorder is caused by the fact that I have hair and I need to shave my head to not feeling anxious anymore. And I have the best hair. I love my haircut. I have the best hair stylist, so I’m just like, “No, I don’t want to shave my head.”

Kimberley: You don’t want to go all Britney Spears on yourself.

Jazzmin: No. But it’s so funny to me how that works and the way-- yeah, I lost my train of thought there because we were laughing about Britney Spears, but--

Kimberley: But no, I think going back to what I was saying is I think you’re right. I think that we judge ourselves based on whether we’re anxious about something, like, “Oh, I shouldn’t be anxious about that.” But that’s just our brain doing its thing.

Jazzmin: I was holding a newborn baby that I was related to for the first time in my whole life. Of course, I’m going to be terrified. I’m going to throw her against the wall. That’s a normal thing to feel really anxious about. But I think also when you’re in recovery, there’s a certain acceptance you have with anxiety. You learn that anxiety is going to be a part of my life and I’m going to accept it. And I’d always thought that I had done that. And then I remember doing ERP School this last spring. And you mentioned something about, I believe it’s willingness versus willfulness. Is that what it is?

Kimberley: Yeah.

Jazzmin: And I remember feeling angry with you when you mentioned that because I knew you were right. And I was like, “No,” because that was that missing piece that I had yet to figure out. I was always like, “Yeah, I get that I’ll have to feel anxious sometimes in my life. But I’m only feeling anxious and allowing myself to feel anxious because I hope that that will be the key to get rid of it.” So, it was just, that was always the way out. And for the first time, I had to realize that while I was allowing anxiety to happen, I wasn’t really welcoming it in a way. And so, that was what unlocked that little portion in my head.

Kimberley: Okay. So, I just have a question. The therapist/educator in me is like, tell me more – you obviously took ERP School – what is it about? And I’m so happy that that was helpful. But I want to know, because you’re not alone. I love knowing when things make people mad because it means there’s a roadblock there. There’s a common human roadblock that we all get to. So, what about that made you mad? I’m so curious.

Jazzmin: Yeah. I think in all honesty, it was a little bit of resistance because it was like, I knew that that was that next step and I really didn’t want to do that. Everything that I’ve ever done was to get rid of my anxiety. Even my OCD, all of my research, and all of the exposures that I worked on was only to get rid of that anxiety. And at the beginning of every video, you talked about, you said, “Hey, if that’s your goal, let’s reframe that.” And I was just like, “How do I do that? How does someone want to feel anxious?” I just really struggled with understanding how-- it’s such a terrible feeling. I hate it so much. How am I supposed to be happy to experience that? And I wasn’t sure how to connect those two. 

I also was always looking for someone to just tell me how, like to give me steps and just say, “Hey, this is how you become willing to be anxious, or the willfulness, this is how you do it.” I remember talking to my therapist about it and I just said, “Kimberley was talking about this, and can you just tell me how to do that?” I was like, “How do I lean in? Is that something I should just tell myself? Is it something I need to write down?” And she just said, “I think it’s not something I can tell you. I think it’s a little more abstract than that.” And I just said, “Okay. So, you can’t give me a step-by-step on how to get out of this,” because that’s how I am. And she just said, “No, I think it’s a feeling.” It scared me more than it made me angry. And I think that’s why it made me angry because I knew that that was what I needed to do. So, that anger really comes from fear of just knowing what’s next and what I need to do. And it’s something I think I’ve put off for a very long time.

Kimberley: Yeah. Listen, this week alone, I’ve had multiple of these conversations with my clients. I think it’s such a common roadblock for everybody. Like how often people who have recovered said, “When I stopped trying to not be anxious is when I actually got relief from my anxiety.” And it’s like what you resist, persist, is always this sort of thing.

Jazzmin: Absolutely.

Kimberley: I love that you told me that. Number one, I’m terrible. I always giggle when people say that my stuff made them mad because I’m like, “What happened?” But I think it’s such an important point, right? It’s such an important piece of the work. So, how would you encourage people to manage relapse or lapse?

Jazzmin: Yeah, I think I was really lucky to have my sister by my side through this relapse, especially if someone who understands OCD. And encouragement was a huge thing in having a support system because I had my husband, I had my sister, I have grown a community on Instagram of people that know I have OCD and I don’t shy away from putting on my Instagram like, “I’m relapsing right now. Give me a minute. Let me figure this out.” And my comments are always flooded with like, “You got this. We believe in you. Hang in there if you need anything.” And so, I think that was a huge part of that healing for me, was just the support. 

But I also think there’s a huge part about self-compassion that fits into this, about allowing yourself the opportunity to stumble. And I think it gives us its humanity. We’re going to fall and we’re going to trip and that’s going to happen. And also, life is not perfectly straight and boring where nothing bad ever happens. That’s what makes life exciting. So, I think there’s a big self-compassion piece to it all of just allowing yourself to be wherever you are.

Kimberley: Is the self-compassion piece the work you’d, like you’d said, sometimes when we relapse? And I’ve had these conversations. It’s like, “Oh, there’s a layer of your therapy that you hadn’t done, or that this is a good thing for your long-term recovery.” Was the self-compassion work you had previously done or did you have to take on the self-compassion once you realized you had relapsed?

Jazzmin: Self-compassion was not at all a part of my previous healing and it was something that I was really missing. I bought your book too, The Self-Compassion Workbook. I wrote through when I was on an airplane ride once. And again, it also made me frustrated because I remember you had me write like how I felt about me if my OCD was flaring up or what I thought to myself about the fact that these intrusive thoughts were present. And all of the things that I wrote were really nasty about myself like, “Why are you thinking that? Even if I know everyone has intrusive thoughts, people don’t have those ones or they don’t make them feel the way that mine make me feel. So, I’m not strong enough or I’m not doing well enough or I’m not as well as I thought I was.”

And so, self-compassion was that layer of my healing that I don’t think I had reached yet but I think I really needed because again, I think I have that tough girl mentality and I want to be strong for everybody. And when it comes to doing that for myself, I fall short. So, I think it was really helpful to just learn, to give myself grace and to watch the way that I was speaking to myself when I was struggling and allowing myself to struggle, allowing myself to feel bad because that’s life. 

Kimberley: Yeah. I love that you had support. I love that you had those people cheering you on, like clapping their hands, “You can do this.” What would you encourage people to do if they didn’t have that support? And in the same question, were you able to start to have that voice? Where you were like, “I can do it” and have that kind of coaching voice as well? Or was that not a part of your experience?

Jazzmin: So, I think if anyone doesn’t have that support, the first thing I would encourage them to do was to find the community online because that’s how I mostly got that sport in the beginning, was just finding people that were struggling in a similar way. But also, I think a huge part of that self-compassion in your voice is to be that voice for yourself and to be an advocate for yourself in those moments. And so, yeah, I think there’s a part of just doing it for yourself in a way. And there was a second part of that question you asked.

Kimberley: No, no, you answered it beautifully, because I think that is a piece of it too, is I have found for myself and I could be-- you may not feel this at all or the listeners may not feel this at all, but a huge part of my self-compassion journey was instead of going to other people to cheer me on, I had to learn to do it myself. Not to say you don’t deserve to go and get it. It’s not a problem if they cheer you on, that’s not a problem at all, but that was a huge piece of it. And I try to practice that with my patients as well, like can you cheer yourself on just a little, can you reframe that you’re strong while you suffer kind of thing. I think there’s so many reframes that we can make.

Jazzmin: Yeah, absolutely. And I think back to the things that I did to encourage myself and I remembered one thing that I did is, I would have a full day of negative thoughts and negative intrusive thoughts and really struggling. And then maybe for two minutes out of that day, I would feel this overcome of like, “Hey, I got this. Wait a minute, I can do this.” And I’d always snap a selfie when I was feeling that. And so, over the course of this relapse, I have tons of these selfies and some of them I’m crying in and some of them I’m in the coffee shop or I’m in my car. And when I was really feeling down, I’d look back on that and I’d be like, “Hey, that’s the version of me that’s cheering me on right now.” And I would look back on those photos all the time and be like, “Hey, yesterday at 2:04 PM, I felt okay for a minute.” And even if it was just a minute, I’m going to trust that girl right there, because that’s who I am.

Kimberley: Wow. That’s so cool. I love that. I’ve never heard that before. What an amazing way to capture you in that moment. I love that so much.

Jazzmin: I think I put it in my phone, in my folders as reminders of hope. And I would look at those pictures whenever I needed it because I think seeing proof that you were there at one point too, it’s like, that was me and I could be there again.

Kimberley: I love that so much. I actually think that that’s a piece of the tool belt or the toolkit that we need to have more of, like how can you remind yourself that you’re in the game and you’re doing the game. I love that so much. I remember many months ago, I did a podcast with Laura. I can link it in the show notes. She talked about, she did a collage of photos of her doing her exposures, even though she’s crying or even though-- and I just think that’s it, right? Just to remind ourselves that we’ve been there and we’ve gotten through it is so huge. 

This goes back to the very beginning, but how do you-- is there a difference in how you respond depending on whether it’s a lapse, your version of a lapse or a relapse? For you, is the response and the tools you use the same or is it different? 

Jazzmin: I think for me the tools are about the same. I would almost say I use less tools in my lapses and that’s always what causes them. So, I relax into this anxiety that I’m feeling and I let my guard down maybe a little bit and I start doing something. But generally, the way that I spot myself out of those cycles is to-- I quite literally will map out. I’m like, “What thought just made me anxious, and then what was my initial-- what did I feel like I needed to do to make myself feel better?” And then once I could take that step back, I could see what was going on. And I think my relapse was a little bit different because it reached that core fear of mine about feeling anxious forever or feeling like I wasn’t going to get rid of it. And so, I think it was a little harder to find that exit of that loop because it was something that I was so deeply engraved in my being that I’ve had for so long that I don’t think I ever really looked at. I always treated the surface of my obsessions and never really realized what is the core of this. It’s feeling anxious. It’s just this fear of anxiety.

Kimberley: Yeah. And how are you doing now? Can you give me a realistic description on how to recover with OCD Relapse? 

How to recover from OCD relapse

Jazzmin: Yeah. I would say I’m doing really good right now. I’m actually 16 weeks pregnant. We found out we were pregnant back in May. And so, pregnancy is one big exposure because as someone who doesn’t like not knowing the future and is not great with uncomfortable sensations, that is pretty much all this pregnancy has been. But I remember explaining to a friend like sometimes when you’re pregnant, at least for me, I’ll just have these waves of sadness. Nothing is making me sad. I’m actually having the best day ever, and I’ll just have to go cry really hard for 10 or 20 minutes. And I was thinking to myself, this is something a couple years ago that would really scare me. I’d be really fearful of these feelings. And I have just come so far in my journey with anxiety and OCD that when I feel that way, I just surrender to it and I say, “Hey, babe, I’m going to go upstairs. Give me 10 minutes.” And I’ll just go hang out in the bathroom and let it out and wipe my tears away and just allow that I’m going to feel that way sometimes and it’s okay and I think so.

So, right now, I’m doing really well and navigating, of course, pregnancy as much as I can as it’s super new. And of course, I have a lot of fears about being a mother and when those intrusive thoughts will show their face again, when I’m holding my baby, which I’m sure they will. But I’m really leaning into this idea that the version of me that will make it through that will be born in that moment. So, there’s nothing I can really do right now to make that intrusive thought not stick as much when it happens. All I can do is just trust that when it happens, if it happens in that moment, I’ll gain whatever resilience I need to work through it. And there’s a lot of self-trust that comes into that. And really trusting that I’ve got this and who knows, maybe I’ll stumble and I am fully allowing myself the opportunity to do that. So, I think that’s just been a big part of this journey for me, is allowing the unknown to just exist. 

Kimberley: I love what you’re just saying. In fact, I have had clients who’ve actually written invitations to OCD like, “I welcome you to my baby’s birth,” or “I welcome you to my wedding,” and so forth. And so, I think that this is beautiful in sort of an insurance policy for relapses to say, “I’m inviting you to this big event,” which is what you’re doing.

Jazzmin: Yeah. It’s like, “Let’s join me. I know you’re a part of my life and I want to see what are you going to throw at me. Let’s do this.” Almost like, “Let’s do this together. It’s not a fight and I don’t want you to go away, but I’m curious to see what you’re going to bring to the table and I’m looking forward to seeing how I handle it, learning whatever I need to learn in that moment.”

Kimberley: See, you have a lot of willingness.

Jazzmin: Now I do.

Kimberley: You have got it. I’m so grateful to have you on and to share your story. This is so good. So good. Tell me-- let’s just wrap it up with like, okay, someone is in the depth of their relapse, they’re the lowest of the low. What words of wisdom do you have for them?

Jazzmin: Feel it. I think that’s what I would say. I think when you’re in those lows, you’re always looking for that way out. And of course, naturally, you want a way out. There’s no way you want to be there forever. But I think just really leaning into this idea that the only way out is through and just really feel what you’re feeling and don’t be scared of it, because I think fear really holds us back from a lot of healing.

Kimberley: So beautiful. Thank you so much for coming on.

Jazzmin: Thank you so much. It’s so much fun. And I just want to say, I want to sing your praises for a minute. Your podcast and just you as a person are so kind, and I really found that just your content and just your presence was so comforting in the time of really darkness for me. And I think sometimes when you’re going through OCD, you have a lot of people that have that fight mentality and they’re like, “You got this. Just go at it, run at it.” And you just showed a level of gentleness in approaching that. And that was what really helped me find that self-compassionate voice. So, I just want to thank you from the bottom of my heart for the things that you do and what you do on here. It’s incredible.

Kimberley: Oh, thank you. I’m covered in goosebumps. I can’t tell you-- I say this every time, is when you’re here talking to a microphone and no one’s there, sometimes you don’t really know who you’re touching and I just love hearing that. Thank you, because it really means so much to me that I could be there without even knowing that I’m being there. So, it brings me just so--

Jazzmin: Sometimes you just need to know. You need someone to tell you like, “Hey, what you’re going through is hard and it’s okay that it’s hard.” And I think that’s something you’ve always done for people, that we can do hard things.

Kimberley: We can. It’s a beautiful day, right? 

Jazzmin: Uh-hmm.

Kimberley: Thank you, Jazzmin. You have been such an inspiration. If people want to follow you, where can they get ahold of you?

Jazzmin: So, my Instagram is where I’m the most vocal. It’s Jazzmin Lauren. My name is weird. J-A-Z-Z-M-I-N. I have a jazz musician as a father. And I would say I’m not super vocal on big advocacy stuff on my social media. My goal is just to share my life as someone with OCD. So, my DMs are always open though. If you ever want to reach out and just say hi, or if you want help finding a therapist, I know how to do that and I’m always willing to help. So, yeah, you can find me there.

Kimberley: You’re amazing. Thank you so much.

Jazzmin: Thank you.

Sep 2, 2022

Welcome back, everybody. I am so excited to be here. This is my first recording since returning back from Australia, after having five and a half weeks in Australia with my family and I could not be more thrilled. I had the most incredible time. I tell you, my cup was overflowing by the time I left. My heart was full. I didn’t realize that my heart was very empty, even though I have so much love in my life and joy in my life, and in many areas of my life, my cup was so full. But I didn’t realize how much my heart needed to go home and actually just live in Australia for five and a half weeks and let my kids learn what it’s like to live in Australia and be in Australia. It was so wonderful. I’m just so incredibly grateful to have had that opportunity.

That being said, I’m really also very, very sad to be back. However, I am making a choice to love-- how can I say it? Like love all of the parts of my life – the hard parts, the good parts, the easy parts, the parts that still don’t make sense to me. I’m making a point to love all the parts and feel all the parts and be gentle with all those parts. And I’m guessing you have some-- well, it may not be that exact experience. I’m guessing there’s some part of your life that you have to practice that with as well. And I strongly encourage it because it just opens up an opportunity for compassion and kindness and no more fighting in your mind. It’s just like, yes, it’s hard being an adult or a human. It’s hard, right? But again, it’s a beautiful day to do hard things.

300 Are Intrusive Thoughts Normal or Dangerous Your anxiety toolkit

This week on this episode, I’ve actually been wanting to do this episode since I left, because this was one that I was almost going to record before I left and I just ran out of time. It’s funny, I do a lot of Googling for my job, not for reassurance reasons, but often will type in a keyword just to see who’s talking about certain topics and how I can talk about it better with my clients. And often when I type in “intrusive thoughts,” you know how in Google, it auto-populates what it thinks you’re going to ask? It often asks, is intrusive thoughts normal? Are they normal? And the other one that often comes up is, are intrusive thoughts dangerous? And so, I wanted to talk about that because if that’s one of the most Googled questions, well, let’s talk about it. Okay, let’s talk about it because it’s another common. It’s the question that we get asked with my staff. I have a private practice. We have 10 amazing therapists. It’s probably one of the most common questions people ask on their first session. So, let’s talk about it. 

Okay. So, the first question is, are intrusive thoughts normal? Well, let’s first get a feel for what is an intrusive thought. Now an intrusive thought is a thought that is intrusive. Meaning you don’t want it. It happens automatically. It just pops into your mind. It’s usually repetitive. It’s usually distressing. Often it will go completely against your values, but not always. Sometimes it could just be a random benign thought, like if you know, we call them “earwigs” here in America. I don’t know what we call them in Australia, but it’s like where a commercial or a song just goes over and over in your mind. That’s actually technically an intrusive thought as well, even though it may not have the presence of anxiety. 

But that’s what an intrusive thought is, and all humans have intrusive thoughts. They’re completely normal. Everyone has them. Even, you may have asked a close friend or a parent or somebody and say, “Hey, I have these intrusive thoughts sometimes, or really bizarre and strange. Do you have them?” And if they say no, I actually don’t believe them. What I’m guessing they’re actually saying is they have them, but they don’t distress them. But they do have them. We all have these thoughts that just randomly pop up in our mind that make absolutely no sense, that have absolutely no relation to what we’re doing. So, as you’re out to lunch with your friends, you might have this most bizarre thought. That’s what our brains do. They come up with some bizarre things, just like sometimes our brains have bizarre dreams. 

So, when we’re talking about this question – the question being, are intrusive thoughts normal – the answer is yes. They’re very, very common.

Now, the next question that often gets asked is a variation of this question, which is, what intrusive thoughts are normal? And I’m here to tell you all of them, every single one of them. When we talk about normal, we’re talking about what is average, what the average human experience is, and all of them are.

Now let’s actually get straight to the weirdness, shall we? You’ll most likely find that you have these intrusive thoughts during the most peculiar times, like when you’re making love to somebody or having sexual relations with someone, while you’re making a phone call to talk to, or when you’re making eye contact with someone. Maybe it’s someone your boss, or someone who you normally wouldn’t have these thoughts about and you normally wouldn’t welcome these thoughts about – that’s when you’re going to probably have them. When you’re on a first date, when you’re changing a baby’s diaper, when you’re handing, let’s say, you’re working behind a cash register. As you hand the money to the person is when you’re likely to have the most bizarre or strange intrusive thought. That’s really, really common, so I want to normalize that for you.

Now when I use the word “bizarre” or “strange,” that still has some judgment to it. So, I want to call myself out on that. Our job is to take judgment out of intrusive thoughts. The reason we often struggle with them is because we tell ourselves, “Oh, there are some thoughts that are good and some thoughts that are bad. And there are some intrusive thoughts that are good. And there are some intrusive thoughts that are bad.” And I’m here to tell you, or I’m here to remind you that there is no good or bad thoughts. They’re all just thoughts. There is no good or bad scenario in which you can have intrusive thoughts. Meaning it’s not bad to have intrusive thoughts during sexual intercourse, because we tell ourselves that, or it’s not good or bad to have thoughts when you’re with your baby or you’re at work with your boss or you’re doing homework, thinking about your teacher, or you’re thinking about someone you deeply love. There’s no right or wrong thoughts to have. They’re just thoughts. They’re thoughts. They’re projections that show up in our brain. 

The only reason they become a problem is when we frame them as a problem that has to go away. And so, again, the main core message of today is, let’s not treat thoughts like problems. Let’s not treat the anxiety associated to it as a problem. And I do understand it’s painful. I do understand there’s a large degree of suffering there, but a lot of the time, the suffering comes from the fact that we’ve told ourselves, or we’ve put this expectation on ourselves that there’s a right and a wrong way to have intrusive thoughts, or there’s a right thought and a wrong thought to experience in your mind. Let’s not do that anymore. Let’s just let thoughts be like raining cats and dogs down on our mind, and we let it rain and rain, cats, and dogs in whatever form it is. Whatever thought and whatever content it is, we just let it come. Okay? 

Now, let’s look at the other big question that people have that seem to be Googling, which breaks my heart, which is, when do intrusive thoughts become a problem? And I’m here again to tell you they’re never a problem. They’re never a problem. I don’t want you to think about intrusive thoughts or frame them as a problem. 

Now, let’s get a little deep into that though, because it’s not as black as white as I’m saying it is. So, if you are someone who experiences intrusive thoughts, which we all do, and yours are associated with a large degree of suffering – anxiety, panic, uncertainty, dread, sadness, grief, like again, raining cats and dogs – it’s like you’re having intrusive thoughts and then all the emotions, rain, cats, and dogs around you too. Am I right? When you’re having that experience, I totally get that that is a large amount of suffering that you experience with the intrusive thoughts. 

So, again, I don’t want you to feel like I’m gaslighting you or diminishing the suffering that you experience around your intrusive thoughts. But we will say that when we get really close and we get the magnifying glass really out and look, when we have the intrusive thought and you have the consequential or resultant anxiety and sadness and suffering, it really only becomes a problem. I don’t love the word problem, but I’m just going off the question. When we respond to that thought with criticism and punishment and self-judgment, and we beat ourselves up for having a brain that created and generated thoughts, that’s the real problem that I see. 

So, when do they become a problem? They’re not, but they can become a problem if we then beat ourselves up because when we beat ourselves up, now we’ve got two problems. We’ve got the suffering of the intrusive thought and we’ve got now you’re beating yourself up and suffering even more. 

Sometimes when we have those thoughts, we then go on to do other compulsions to try and get rid of those thoughts as if those thoughts were problems. So, we could see where this becomes a loop. If you have a thought and you tell yourself they’re wrong and that they’re a problem, you’re probably going to beat yourself up, which is doubled the suffering. And you’re probably going to do some pretty stretching, long painful behaviors to get rid of it, which is adding even more to your suffering.

So, what we want to do is if we look at that like it’s a cycle, instead of judging and instead of responding with some kind of compulsive safety behavior, we can actually intervene at the thought at the top of this chain of reactions and go, “Okay, I’m having thoughts. I’m allowed to have them. I’m going to have them. Humans have them. They’re not a problem. I’m not going to treat them like a problem, even though my whole body wants to treat them like a problem. But I’m going to be really gentle and shift the way I respond from one of being critical and responsive to one of being accepting and compassionate.” 

And the last question here is, are intrusive thoughts dangerous? That’s what I consider to be the most extreme framing of an intrusive thought, that thoughts are dangerous. And here I want to say to you, no, thoughts are not dangerous. Thoughts are thoughts.

Now, again, let’s drop down a little bit deeper and look at this a little closer. You can have thoughts about dangerous things. That’s different. Meaning thoughts about unicorns aren’t dangerous. We can all agree with that unless you have a specific phobia about unicorns. We can laugh at that, but some people do. It’s like some people’s thoughts attack many areas in our lives. So, you can have a thought about a unicorn and we can all agree that that’s not dangerous. But for some reason, if we had a thought about hurting someone we love or dying, which might have the theme of dangerousness, we then go, “Oh no, that thought is more important because it’s about danger. It’s more important. My thoughts about what I’m going to have for lunch or my thoughts about will I be late for this meeting, that’s not a big deal. But my thoughts about harming people or hurting people or something bad having to myself, well, that’s a dangerous thought.” No, I’m actually going to say, that’s not a dangerous thought. That’s a thought about danger. Or if we go a little deeper, it’s a thought about a possibility of danger, not even an actual certainty. 

And so, what I’m really wanting you to do as I walk you through these is to learn to have a different perception of thoughts, and learn to be mindful about the thoughts that we’re having. So, instead of having a thought and assuming that your thought is a fact, which thoughts are not facts, instead of doing that, we’re going to go, “Oh, I’m having a thought about such and such,” or “I’m having thoughts about these thoughts,” even to go even more deep into the mindful meta response. 

So, here is where we shift our reaction, and what I’m going to offer you as I finish up this episode is double down here, if you can, on how you frame thoughts and how you perceive thoughts, and how you respond to thoughts. Make it your agenda for this week, month, or year or decade or life in that you start to practice observing thoughts and without framing them as a problem, dangerous, abnormal, as there’s something wrong with you because there’s nothing wrong with you. We all have these thoughts. Some of us have more than others, yes, but that still doesn’t mean there’s something wrong with you. Some have more suffering related to them, absolutely, but I still want to frame that it doesn’t make you a faulty, broken human. That’s not what this is about. Thoughts do not generate worth. Meaning if you have good thoughts, you have lots of worth, and if you have bad thoughts, you have very little worth. That’s not a thing. We just want to go back to thoughts being what gets projected in our mind and not give them all that power. 

So, that’s the pieces that I want you to take. Take as much as you need from today. Some things may feel really true, like I’m speaking directly to you. Some may feel like, “Ah, that doesn’t land for me so much.” That’s okay. Take what you need. Consider what your experience of this conversation was, if you got triggered at some point or you feel really angry at some point or resistant or absolutely wonderful. Sometimes this can actually also start to become a compulsion in that you listen to this over and over to get reassurance that you’re not a bad person. So, check with that as well and ponder on it. Take what you need. Learn from it and what you needed to hear today. 

Before we leave, let’s do the “I did a hard thing.” This one is short and sweet. This is from Natalie. Natalie said: 

“I had pre-cancerous cervical cells removed yesterday and I was so anxious, but I did it.”

So amazing, Natalie. I love this. Now, it’s short and sweet, but I actually think that’s a really, really hard thing. That takes some courage. So, I’m super, super proud of you for that. You should be so proud of yourself. 

And then before we finish up, we have a review from Coronacouchpotato, and they said:

“Brimming with resources. A friend referred me to this podcast and I am so grateful. I had received more helpful information in the past couple weeks listening to this podcast than I have in the past year or so in therapy. I tell everyone I can about this podcast and how it has changed my life. Thank you, Kim!”

Oh my goodness. Coronacouchpotato, I cannot thank you enough for your review. 

I will tell you a little story. I realized while I was away in Australia that I need to slow down enough to really be connected with the people who I am helping. Sometimes I think I go, go, go so fast, and I have this idea of helping all these people. I actually have to slow down and think about like, wow, it’s so cool that Coronacouchpotato and I are doing this together. And Natalie and I, we’re doing this together. And for you, even though I’m not saying your name, we’re doing this together. Isn’t that so cool? 

Oh my gosh, it’s so beautiful. It’s so beautiful. And so, thank you, thank you, thank you for allowing me to be on this journey with you. I am honored. Thank you for trusting me. And if you would love to leave a review, I would love to feature it. So, go ahead and do that. 

All right, folks, have a wonderful day. It is a beautiful day to have all the intrusive thoughts. 

I’ll talk to you next week. Thank you again. Amazing for 300 episodes and I’ll talk to you soon.

Aug 26, 2022

This is Your Anxiety Toolkit - Episode 299. 

Welcome back, everybody. 299, wow. That is amazing. I am so excited. I don’t know what it is about the word 99 that just makes me so joyful. 

One of my favorite episodes is actually number 99, which was the only episode and the only time where I actually have a full conversation with my husband on the podcast, and we talked all about agoraphobia and panic disorder specifically related to flying. So, if you want to hear me and my husband have a good conversation about his experience, that was one of my favorite episodes of all time.

But here we are, Episode 299, 200 episodes later, and we’re still going strong. No need to slow down. If anything, let’s speed it up a little. Shall we?

Before we get started on this week’s episode, I am going to do the two segments that we do every week. First, I want to give you a little bit of a peek into where we’re going today. So, what we’re talking about is a question I get all the time, particularly when I’m talking about having a chronic illness. Specifically for those of you who have a chronic illness and have a mental illness as well, but also, this could be just for anyone because this is a human problem, this is not a mental health problem. 

We’re talking about balancing exhaustion and when you have to “push through” and what do you choose? This has been a huge part of the work for me in my recovery from having postural orthostatic tachycardia syndrome. I feel like I’ve nailed this. To be honest, this is an area that I have learned very, very well, and it has saved my life literally in terms of I would be crashing and burning with tears and a major tantrum if it weren’t for my ability to balance, rest and push through. So, let’s talk about that in a second. 

First of all, we’re going to do the review of the week. This is from Carsoccer27, and they say:

“There are a lot of things that this podcast has helped me with. It’s a great toolbox in many of my anxiety triggers. I never knew where to start to help my anxiety. This podcast has helped me find my starting place and has helped me find my self-identity. Highly recommended!”

Thank you, Carsoccer27. What a beautiful thing to say. To be honest, for someone to say that I’ve helped them find their self-identity, that is an amazing compliment. That sounds amazing to me. So, I’m so happy I’ve been able to walk along you in the journey of that. That’s just so cool.

Okay. We now have an “I did a hard thing” from Anonymous. Anonymous said:

“I did an exposure exercise. I get anxiety when I’m around people. So, it was hard for me to get groceries at the store, but I conquered my fear and got the groceries. And another important one is that I graduated college dealing with what I deal with.”

Anonymous, I love this. What I love about this the most is you talk about your struggle to get the groceries while also adding graduating college. Two massive things. Two major accomplishments. And I’m so grateful for you that you shared that because I think some people have said to me like, “Groceries, everybody’s getting the groceries. I should be able to do that.” But I love that you’re celebrating how hard that was for you. We all need to do a better job of celebrating when we face a hard thing, whether bigger and small.

299 Balancing exhaustion and having to push through Your anxiety toolkit

Okay. So, let’s get into the episode. All right. Thank you first for Carsoccer27 and Anonymous. Let’s talk about balancing this push and rest. This balance between push and rest. If you could listen to me right now, you could see me. I’m swaying back and forth like a teeter-totter or a seesaw. It is a balancing act. 

So, let’s just get the truth out. Having a mental illness or a medical illness is the most exhausting thing, and people will not get it. They will not get it until they’ve been through it. They don’t understand the degree of exhaustion that you are experiencing. So, I first want to just straight up validate you. It’s okay that they don’t get it. It doesn’t mean that you’re not validated and that you aren’t as exhausted as you are, because you do have to go through it to get it. So, let’s just be real about that. 

Now, even though you are exhausted, you still are going to have to have times in your life where you have to push through to get stuff done. Anonymous is a great example of this. They push through despite going through anxiety the whole time, just push through, got through college. But what we have to be careful of here is this push through mentality. I’m actually right now reading a book by Ed Mylett and it’s called Max Out Your Life. I personally love it. It’s so inspirational. And as I’m listening to it on Audible, I’m like, “Yeah, let’s max out our life.” It’s so empowering and I just want to flex my muscles until I’m like, “Wait.” The anxious workaholic in me and the perfectionist in me wants to take that literally. And in the past, I have where I’m like, “Yeah, let’s max out our life. Let’s just push through and just push and push and push.” And then as I’ve said to you in the intro, I collapse and everything goes into a big pile of mush. 

So, this is where we call it balancing. It’s a great idea and yet, it’s so empowering to hear that. But it’s not healthy to take on a high percentage of push through mentality. So, if you’re hearing this on social media and you’re reading books about it, listen with a little bit of a skeptical ear. Because you are already exhausted, pushing through more is probably going to tip the scales so that the scales tip over and you don’t recover at all. You’re actually in big trouble. 

What we want to do today is we actually want to really learn the art – again, I’m swinging back and forth now – the art of balancing, the push through, and then making sure there’s time to rest. So, you do a little bit of a push through, you get through the class or you get the groceries or you pick up your kids or you go to a dinner that you don’t want to go to that exhausts you. And then you balance that with rest. 

Now what I mostly hear my clients say is, “But Kimberley, I shouldn’t need to rest for that one thing. Everybody else is fine. I shouldn’t need to rest.” And this is where I’ll often say-- I look at them dead in the eyes. So, imagine I’m looking you dead in the eyes right now and I’ll say, “But whether other people are exhausted or not, you are and you have to radically accept it and you have to listen to your body.” It’s completely not even a calculation we need to take into consideration on how other people are handling it. You are exhausted. That’s the fact. And so, we do need to balance this teeter-totter, this seesaw of you push a little and you rest a little, you push a lot and you rest a lot. There’ll be times where you push a little and you still have to rest a lot. And that is, you’re doing it. The way I think of it is, if I rest enough today, I’ll have more energy for tomorrow so I can push through a little tomorrow, because you do. When I say push through, I mean, just get the things you value done. I’m not saying go hard and max out when you’re already exhausted. I actually don’t think that’s super helpful. I’ve fallen into that trap way too many times.

The other thing here is, a lot of times, when we “push through,” meaning we have to. We have to show up for our kids and our partner and our boss and our parents and whatever, yourself. So, you’ve done that. And then when you go to rest, you look at Instagram and you watch some TV. There’s nothing wrong with going on Instagram and watching TV at all. I do it myself. But I want you to really just use this. Again, I love to ask questions. So, the question I’m going to ask you is, is that in fact restful? Does that actually fill your cup up, restore you? Because if you’re pushing through, you’re using up energy, you’re using up resources, you’re using up time, you’re using up your mental space. Does the resting that you’re doing actually restore you? If it’s no, I very much encourage you to take a look at what might be restorative for you. 

Often people will say, “Nothing is restorative. Even when I rest, my anxiety is going through the roof.” And so, that’s where I would say, “Okay, if that’s the case, you may need to actually push through in terms of really double down with your treatment, really double down with your mindfulness, that’s the pushing through, so that you do learn how to rest.” 

Often by the time a client comes to me or one of my staff, they’re already exhausted. They’re already depleted, because they’ve been trying to work through this disorder by themselves for a very long time. And so, when we say, “Buckle up, let’s get going with exposure therapy or we’re going to do mindfulness and we’re going to practice these skills,” they might be like, “Dude, I’m already exhausted. I don’t even have the capacity to do that.” And so, we’d say, “Yeah. This is an example of how we’re going to double down now, “push through” so that we can balance that exhaustion, so we can take away the thing that seems to be exhausting you.”

So, again, it’s a push and a pull. It’s a little balance game. It’s like juggling, and juggling requires a rhythm and a balance and a practice and a consistency that you’ll have to find for yourself. But I strongly encourage you to spend some time looking at this because I think we hear too much about the push through on social media in society. And then on the flip side, we also have like, “Oh, you’re exhausted. You should rest.” And that’s true. But resting alone won’t get you better. So, it’s this dialectical two opposing things happening at the same time. 

So, that’s what I want you to think about. An example for me, I’ll just give you a quick example. When I was really sick and my husband was working so much, I had to push through because I had to take care of two young children. I didn’t have a choice. What I did do, though, is when I was “pushing through” and even though I was so exhausted, I then challenged. While I’m pushing through, what am I doing that makes this more exhausting and how can I make it less exhausting? 

So, an example, often with clients, they’ll say, “I have this test and I have to just push through, I have to study for it.” And I’ll say, “Okay, while you push through, and while you do that hard thing,” because pushing through is another word for just saying doing the hard thing, “as you do the hard thing, is there anything you can do to lessen the stress on your body? Could you maybe not tense your neck and shoulders so much? Could you breathe a little more? Could you take some more breaks? Could you have a bottle of water? Could you take little moments to breathe and do a little mindfulness or meditation exercise?” 

So, the thing here is you can also be resting while doing little intervals of pushing through or doing the hard thing. For me, that was a crucial piece. While you’re pushing through, you’re letting go of stuff that doesn’t matter just to save yourself the exhaustion of taking that story on or that rule on or that expectation. While you push through, maybe lower your expectation. That might be helpful. Maybe lean in with a large degree of self-compassion and like, “Wow, Hun, you’re pushing through, you’re doing this hard thing. I’m going to be so gentle with you while you do this hard thing.” That’s so beautiful. Such a beautiful act of kindness. And then by doing that-- or when you’re exhausted and you’re resting and you’re feeling guilty for resting, you’d say, “Hun, you’re resting and this is so hard for you and this is triggering for you. Keep going. So brave. Keep going. I’m so grateful that you’re taking this time to rest for me.” Cool, right? 

All right. That’s all I have for you today, guys. Just play with this. There has to be a balance. If this is still confusing for you, put it on paper, write down how many hours a day you push through and how many hours you rest, and just say, how can I increase the rest by 15-minute increments? What would that look like for me? What would that feel like for me? What would be helpful? Where can that be possible? How can that be possible? And maybe that 15 minutes will make a world of difference. It’s better than nothing.

I’m going to take a deep breath with you. I’m going to hold my heart for you. I’m going to remind you that you’re stronger than you think, that the work you’re doing is important and amazing and inspiring, and don’t give up. Don’t give up. Keep tweaking and tweaking and taking baby steps and you will get there. You will get there. 

All right, I’m going to send you so much love. Have a wonderful week. It is a beautiful day, it’s a beautiful week, it’s a beautiful month to do hard things. I’ll see you next week.

Aug 26, 2022

This is Your Anxiety Toolkit - Episode 299. 

Welcome back, everybody. 299, wow. That is amazing. I am so excited. I don’t know what it is about the word 99 that just makes me so joyful. 

One of my favorite episodes is actually number 99, which was the only episode and the only time where I actually have a full conversation with my husband on the podcast, and we talked all about agoraphobia and panic disorder specifically related to flying. So, if you want to hear me and my husband have a good conversation about his experience, that was one of my favorite episodes of all time.

But here we are, Episode 299, 200 episodes later, and we’re still going strong. No need to slow down. If anything, let’s speed it up a little. Shall we?

Before we get started on this week’s episode, I am going to do the two segments that we do every week. First, I want to give you a little bit of a peek into where we’re going today. So, what we’re talking about is a question I get all the time, particularly when I’m talking about having a chronic illness. Specifically for those of you who have a chronic illness and have a mental illness as well, but also, this could be just for anyone because this is a human problem, this is not a mental health problem. 

We’re talking about balancing exhaustion and when you have to “push through” and what do you choose? This has been a huge part of the work for me in my recovery from having postural orthostatic tachycardia syndrome. I feel like I’ve nailed this. To be honest, this is an area that I have learned very, very well, and it has saved my life literally in terms of I would be crashing and burning with tears and a major tantrum if it weren’t for my ability to balance, rest and push through. So, let’s talk about that in a second. 

First of all, we’re going to do the review of the week. This is from Carsoccer27, and they say:

“There are a lot of things that this podcast has helped me with. It’s a great toolbox in many of my anxiety triggers. I never knew where to start to help my anxiety. This podcast has helped me find my starting place and has helped me find my self-identity. Highly recommended!”

Thank you, Carsoccer27. What a beautiful thing to say. To be honest, for someone to say that I’ve helped them find their self-identity, that is an amazing compliment. That sounds amazing to me. So, I’m so happy I’ve been able to walk along you in the journey of that. That’s just so cool.

Okay. We now have an “I did a hard thing” from Anonymous. Anonymous said:

“I did an exposure exercise. I get anxiety when I’m around people. So, it was hard for me to get groceries at the store, but I conquered my fear and got the groceries. And another important one is that I graduated college dealing with what I deal with.”

Anonymous, I love this. What I love about this the most is you talk about your struggle to get the groceries while also adding graduating college. Two massive things. Two major accomplishments. And I’m so grateful for you that you shared that because I think some people have said to me like, “Groceries, everybody’s getting the groceries. I should be able to do that.” But I love that you’re celebrating how hard that was for you. We all need to do a better job of celebrating when we face a hard thing, whether bigger and small.

299 Balancing exhaustion and having to push through Your anxiety toolkit

Okay. So, let’s get into the episode. All right. Thank you first for Carsoccer27 and Anonymous. Let’s talk about balancing this push and rest. This balance between push and rest. If you could listen to me right now, you could see me. I’m swaying back and forth like a teeter-totter or a seesaw. It is a balancing act. 

So, let’s just get the truth out. Having a mental illness or a medical illness is the most exhausting thing, and people will not get it. They will not get it until they’ve been through it. They don’t understand the degree of exhaustion that you are experiencing. So, I first want to just straight up validate you. It’s okay that they don’t get it. It doesn’t mean that you’re not validated and that you aren’t as exhausted as you are, because you do have to go through it to get it. So, let’s just be real about that. 

Now, even though you are exhausted, you still are going to have to have times in your life where you have to push through to get stuff done. Anonymous is a great example of this. They push through despite going through anxiety the whole time, just push through, got through college. But what we have to be careful of here is this push through mentality. I’m actually right now reading a book by Ed Mylett and it’s called Max Out Your Life. I personally love it. It’s so inspirational. And as I’m listening to it on Audible, I’m like, “Yeah, let’s max out our life.” It’s so empowering and I just want to flex my muscles until I’m like, “Wait.” The anxious workaholic in me and the perfectionist in me wants to take that literally. And in the past, I have where I’m like, “Yeah, let’s max out our life. Let’s just push through and just push and push and push.” And then as I’ve said to you in the intro, I collapse and everything goes into a big pile of mush. 

So, this is where we call it balancing. It’s a great idea and yet, it’s so empowering to hear that. But it’s not healthy to take on a high percentage of push through mentality. So, if you’re hearing this on social media and you’re reading books about it, listen with a little bit of a skeptical ear. Because you are already exhausted, pushing through more is probably going to tip the scales so that the scales tip over and you don’t recover at all. You’re actually in big trouble. 

What we want to do today is we actually want to really learn the art – again, I’m swinging back and forth now – the art of balancing, the push through, and then making sure there’s time to rest. So, you do a little bit of a push through, you get through the class or you get the groceries or you pick up your kids or you go to a dinner that you don’t want to go to that exhausts you. And then you balance that with rest. 

Now what I mostly hear my clients say is, “But Kimberley, I shouldn’t need to rest for that one thing. Everybody else is fine. I shouldn’t need to rest.” And this is where I’ll often say-- I look at them dead in the eyes. So, imagine I’m looking you dead in the eyes right now and I’ll say, “But whether other people are exhausted or not, you are and you have to radically accept it and you have to listen to your body.” It’s completely not even a calculation we need to take into consideration on how other people are handling it. You are exhausted. That’s the fact. And so, we do need to balance this teeter-totter, this seesaw of you push a little and you rest a little, you push a lot and you rest a lot. There’ll be times where you push a little and you still have to rest a lot. And that is, you’re doing it. The way I think of it is, if I rest enough today, I’ll have more energy for tomorrow so I can push through a little tomorrow, because you do. When I say push through, I mean, just get the things you value done. I’m not saying go hard and max out when you’re already exhausted. I actually don’t think that’s super helpful. I’ve fallen into that trap way too many times.

The other thing here is, a lot of times, when we “push through,” meaning we have to. We have to show up for our kids and our partner and our boss and our parents and whatever, yourself. So, you’ve done that. And then when you go to rest, you look at Instagram and you watch some TV. There’s nothing wrong with going on Instagram and watching TV at all. I do it myself. But I want you to really just use this. Again, I love to ask questions. So, the question I’m going to ask you is, is that in fact restful? Does that actually fill your cup up, restore you? Because if you’re pushing through, you’re using up energy, you’re using up resources, you’re using up time, you’re using up your mental space. Does the resting that you’re doing actually restore you? If it’s no, I very much encourage you to take a look at what might be restorative for you. 

Often people will say, “Nothing is restorative. Even when I rest, my anxiety is going through the roof.” And so, that’s where I would say, “Okay, if that’s the case, you may need to actually push through in terms of really double down with your treatment, really double down with your mindfulness, that’s the pushing through, so that you do learn how to rest.” 

Often by the time a client comes to me or one of my staff, they’re already exhausted. They’re already depleted, because they’ve been trying to work through this disorder by themselves for a very long time. And so, when we say, “Buckle up, let’s get going with exposure therapy or we’re going to do mindfulness and we’re going to practice these skills,” they might be like, “Dude, I’m already exhausted. I don’t even have the capacity to do that.” And so, we’d say, “Yeah. This is an example of how we’re going to double down now, “push through” so that we can balance that exhaustion, so we can take away the thing that seems to be exhausting you.”

So, again, it’s a push and a pull. It’s a little balance game. It’s like juggling, and juggling requires a rhythm and a balance and a practice and a consistency that you’ll have to find for yourself. But I strongly encourage you to spend some time looking at this because I think we hear too much about the push through on social media in society. And then on the flip side, we also have like, “Oh, you’re exhausted. You should rest.” And that’s true. But resting alone won’t get you better. So, it’s this dialectical two opposing things happening at the same time. 

So, that’s what I want you to think about. An example for me, I’ll just give you a quick example. When I was really sick and my husband was working so much, I had to push through because I had to take care of two young children. I didn’t have a choice. What I did do, though, is when I was “pushing through” and even though I was so exhausted, I then challenged. While I’m pushing through, what am I doing that makes this more exhausting and how can I make it less exhausting? 

So, an example, often with clients, they’ll say, “I have this test and I have to just push through, I have to study for it.” And I’ll say, “Okay, while you push through, and while you do that hard thing,” because pushing through is another word for just saying doing the hard thing, “as you do the hard thing, is there anything you can do to lessen the stress on your body? Could you maybe not tense your neck and shoulders so much? Could you breathe a little more? Could you take some more breaks? Could you have a bottle of water? Could you take little moments to breathe and do a little mindfulness or meditation exercise?” 

So, the thing here is you can also be resting while doing little intervals of pushing through or doing the hard thing. For me, that was a crucial piece. While you’re pushing through, you’re letting go of stuff that doesn’t matter just to save yourself the exhaustion of taking that story on or that rule on or that expectation. While you push through, maybe lower your expectation. That might be helpful. Maybe lean in with a large degree of self-compassion and like, “Wow, Hun, you’re pushing through, you’re doing this hard thing. I’m going to be so gentle with you while you do this hard thing.” That’s so beautiful. Such a beautiful act of kindness. And then by doing that-- or when you’re exhausted and you’re resting and you’re feeling guilty for resting, you’d say, “Hun, you’re resting and this is so hard for you and this is triggering for you. Keep going. So brave. Keep going. I’m so grateful that you’re taking this time to rest for me.” Cool, right? 

All right. That’s all I have for you today, guys. Just play with this. There has to be a balance. If this is still confusing for you, put it on paper, write down how many hours a day you push through and how many hours you rest, and just say, how can I increase the rest by 15-minute increments? What would that look like for me? What would that feel like for me? What would be helpful? Where can that be possible? How can that be possible? And maybe that 15 minutes will make a world of difference. It’s better than nothing.

I’m going to take a deep breath with you. I’m going to hold my heart for you. I’m going to remind you that you’re stronger than you think, that the work you’re doing is important and amazing and inspiring, and don’t give up. Don’t give up. Keep tweaking and tweaking and taking baby steps and you will get there. You will get there. 

All right, I’m going to send you so much love. Have a wonderful week. It is a beautiful day, it’s a beautiful week, it’s a beautiful month to do hard things. I’ll see you next week.

Aug 19, 2022

This is Your Anxiety Toolkit – Episode 298. 

Welcome back, everybody. How are you? It is a beautiful summer day here in California. I love summer. It is very hot, but so happy to be here with you. I’m sitting in my office. I have a cup of tea. I have my little flowers next to me, and I’m just so grateful to have you here with me as well. Thank you for letting me be a part of your journey. I’m so honored. Really, I am. I know you have many options. It’s just an honor to be walking in this journey with you.

Today, I want to talk to you about seven questions you can ask yourself every day. It doesn’t mean you have to ask all of them. They’re just my favorite seven questions. They’re questions I ask myself all the time, the questions I ask my patients all the time. They’re not groundbreaking in that they’re going to change your life, but they will definitely keep you on track. 100%. They’re what I call guidance questions. They’re questions that prompt you to go in the next best direction, take the next best step. So, I can’t wait to share those with you.

Before I do, let’s do the review of the week. This is from Kendall Wetzel. She said:

“Listening to her podcast and following her on Insta--” if you don’t follow me on Instagram, head over to Your Anxiety Toolkit on Instagram. She’s saying, “Following her on Insta has been so great for keeping me in check with my OCD. She’s gentle, positive, and awesome.” Thank you. “So thankful for this free resource.”

Thank you so much, Kendall, for your amazing review. I love your reviews. Thank you for putting in the time to do that for me. It’s a gift. Thank you.

All right. Before we get into the episode, let’s do the “I did a hard thing.” This is from Joy. Joy said today:

“I told my boss I was resigning. It was a hard conversation to have and I overthought everything leading up to it.” Joy, I love that you shared that. We are human beings. We’re doing the best we can with what we have. But Joy goes on to say: “But I did it and it went well. This morning I woke up and I said it is a beautiful day to do hard things and that helped me to get through the day. Thank you.”

Wow, Joy, love it. I mean, such a totally human response. Even though we overthink things, you still did it and that is all that matters. That is all that matters. That is all that matters. So amazing.

298 7 questions to ask yourself everyday Your anxiety toolkit

All right. Let’s get into these seven questions. Shall we?

All right. I’m actually going to do this pretty quickly, folks. I will leave the questions in the show notes. I strongly encourage you if you’re not driving to sit down and write them out and take some time today to journal on them. Again, it doesn’t have to be all of them. You can make it into a pretty PDF. You could print it out. You could make it into a daily journal, prompts. But these questions, I just sat down and I looked at my computer and I was like, “Okay, what are the questions I commonly ask my patients?” Now, of course, I always ask my patients, how are you doing? I also ask my patients like, how was your week? I didn’t include those questions. Of course, I ask the questions again as guiding questions that lead us towards the whole reason you’re here, which is to live the life you want to live and compassionately.

Alrighty. So, here we go.

Question #1: Does does this behavior line up with my values?

So important. Often, I’ll just speak for myself, but I’m going to probably assume that you are just like me, given that we’re both human beings, but maybe not. Maybe you’re way more evolved than me. But often I find myself doing things that don’t line up with my values, because either society told me to do it or I’m on autopilot and I’m doing what I’ve just always done. And so, therefore, I just keep doing it and I catch myself doing it or I’m trying to avoid some emotion or some fear. So, the question is, does it line up with my values? Often it doesn’t. So, this is a question that guides me. I want you to think of it like your north star or your compass. These are compass questions as they guide you back on track. Does this line up with my values? If it’s a yes, proceed. If it’s a no, we might move our way down the other questions, or you might just want to reflect on that.

Question #2: Does this behavior line up with my long-term goals?

The thing around values is sometimes values will contradict each other. I really value being a good mom, but I also really value being a really good therapist. And sometimes I can’t meet both those values. I can’t be a really good therapist and a really good mom every single day. I can just do the best I can, but sometimes I have to go to work instead of being with my kids. Sometimes I have to be with my kids and I have to cancel a client. So, it’s hard. So, the question I ask myself is, does it line up with my long-term goals? Long-term goals. And I’m talking specifically here in regards to recovery. The last few weeks’ episodes are just about this, is getting clear on your goal, holding yourself accountable. Does this behavior line up with my long-term goals?

Question #3: What is one thing I can do right now that lines up with my long-time goals and my values? 

What’s the one thing, not the big thing? I struggle with this one so hard because I like to knock things out. It feels so good. It’s like a little adrenaline high, and I get discouraged when I can’t. So, I have to keep asking myself, just what’s the one little thing I can do right now in that direction? What’s the one thing? Don’t worry about the 17th thing. Just do the first, next best thing.

Question #4: Is this behavior effective? 

This is similar to the other questions. So, again, you might want to ask yourself all of these. You might get overwhelmed. But this is a question I often ask. I think I’ve mentioned in previous episodes, my 2022 goal is to be more effective. Sometimes I’m doing things and I’m like, “This is not an effective use of my time.” Again, you don’t always have to be effective. Sometimes we just do things for the pleasure of doing them or for the process of doing them, or for the joy of doing them. But is this actually reaching the goal? Is it effective?

Sometimes my mom always to say, excuse me, if I kill this phrase, but she’d say, “You’re jumping over quarters to get to pennies.” She’s talking about saving money. You’re jumping over small amounts of money. Excuse me, you’re jumping over big amounts of money just to save small things. I told you I was going to kill that. I did the best I could. So, you’re jumping over quarters to get to pennies. If you live out of America, you’d say you’re jumping over 10 cents to get to a-- you’re jumping over 10 cents to get to 1 cent. But that’s true too. Are you doing one thing to reduce a little bit of discomfort when you could be doing something that would give you way better outcomes? This is very true of those of you who are doing compulsions. Sometimes we’re doing it and we’re like, “No, I just have to get this certainty. And if I get this certainty, well, then I’ll have relief.” But it’s like, okay, is that effective for your long-term plans? Yes. It reduces your short-term discomfort, but it actually increases your long-term discomfort.

Question #5: How willing am I to be uncomfortable?

This is the big one guys. If you’re going to ask yourself one question in your whole day, this is the one. How willing am I to be uncomfortable? Whether it be that you’re facing your fears on purpose, doing an exposure, how willing am I? Or whether it’s just doing something you have to do that you don’t want to do, like Joy told us this morning, she had to resign. Even if it’s something you have to do, how willing are you to be uncomfortable? How willing are you? Are you in resistance to the fact that this is happening? It’s happening. You’re anxious. You’ve got something hard to do. You can fight it or you can allow it.

Question #6: Can I do this for another 10 seconds? 

Oh, I love this one. I love it. I love it. I love it. Here we go. Can I do this for another 10 seconds?

A client of mine once told me this. I think I’ve done an episode on this before, but it was a client of mine many, many, many years ago who said that they’d heard-- actually, I think it was like Grey’s Anatomy or some TV show. Well, maybe it was some research. They said anybody could do anything for 10 seconds. And so, they would say to themselves while they’re doing their exposure, “Can I do this just for another 10?” And when that 10 seconds is up, “Can I do it just for another 10 seconds?” You may increase it to 30 seconds, a minute, 10 minutes, an hour, or you may reduce it. “Can I do it for five seconds?” But it’s a great question. It really challenges this sort of-- we have these thoughts like I can’t do it anymore. But when you ask yourself, can I do it for another 10 seconds, well, then the script gets flipped.

Question #7: How can I make this fun? 

I mean this, even if it’s doing an exposure that is petrifying and 10 out of 10 anxiety, how can we make this fun?

A part of you is probably throwing your phone against the wall and being like, “What the heck, Kimberley? None of this is fun. I don’t want to do these hard things. Go away.” And that’s fine. It’s a question you don’t have to ask if you don’t want, but I want you to ponder, how can you make it fun? How can you make the hard thing fun?

So, as we look at these questions, these seven questions through the lens of it’s a beautiful day to do hard things-- let’s put it into sentences.

It’s a beautiful day to do hard things that line up with your values, because that was question #1: Does it line up with my values?

It’s a beautiful day to do things that-- excuse me, let me say it’s a beautiful day to do hard things that line up with my long-term goals. That’s question #2.

It’s a beautiful day to do one hard thing. (Question #3)

It’s a beautiful day to do hard things that are effective. (Question #4)

How willing am I to do the hard thing? (Question #5)

It’s a beautiful day to do hard things for 10 more seconds. (Question #6)

And last one, it’s a beautiful day to do hard things, making it fun. So, how would I word that? It’s a beautiful day to do fun, hard things. I’m being silly now. But it’s true.

I really want you to think about these. These are my favorite seven questions that I ask my patients. Try them on. See how they feel. If you like them, proceed. If you don’t, that’s fine. Just drop them. This is where you take what you need and leave what’s not helpful.

I really want to remind you, this is not therapy. So, I’m not tailoring this specifically to your needs. So, if it doesn’t feel right, just leave it. Not everything is for everybody.

All right. I love you. Have a wonderful day. It is a beautiful day to do hard things. Thank you so much for your support. Keep doing the hard things and I will talk to you next week.

Aug 12, 2022

This is Your Anxiety Toolkit - Episode 297. 

Welcome back, everybody. How are you really? Just doing a quick check-in.

I love the quick check-in, the drop down into your chest, the drop down into whatever discomfort you may be having. And just take it a minute to actually check-in. So important. How often are you doing this? Hopefully, multiple times every day. 

All right. Today, we are talking about accountability, and this actually came, I was listening to something. I can’t remember even what it was, but someone was having a strong reaction to the word “accountability,” which words matter. They really, really do. But what I think is more important is the meaning in which we place on words. It’s a huge part of diffusing from what we tell ourselves all day. So, the whole point of today is to talk about this important treatment concept or recovery concept. And I’ll come back to why. But it’s so important. It’s so, so important. I’ve got a couple of different views about certain things, so you’ll have to hang with me each. Everyone is so important, but hang with me.

Before we do that, let’s first do the review of the week. This is from Maggie Paulson. Maggie wrote:

“I love this podcast. I’ve never been diagnosed with OCD, but I recognize that I have anxiety. This podcast has helped me to learn more about how my brain works, and her gentle and loving approach to treatment has helped me learn to handle my intrusive thoughts and my anxiety. To say that has improved the quality of my life is an understatement. I’m very grateful for Kimberley and her podcast.”

Thank you, Maggie. You fill up my heart. Thank you so much for your reviews. All of you, even if you just click the five-star review or however many stars you think it deserves. You don’t even have to write a review. You can just give it stars, and that helps me. So, thank you so much. 

All right, drum roll. We have the “I did a hard thing” segment. This is from Anonymous. Anonymous said:

“Today, I manage not to lapse into a behavioral addiction that I’ve been struggling with for over a year. It’s very easy for me to use this addiction as a coping strategy for the stresses in my life. But I realized today that a good life free of this addiction is better than a good feeling that only lasts momentarily.” Oh my gosh, Anonymous, I want to give you a standing applause right now. “Although every day is going to be challenging when it comes to not lapsing into addiction, if I take each day as it comes and have the attitude that it’s a beautiful day to do hard things, I know I can live addiction free.” 

So good. So good, Anonymous. Oh my gosh, lLet me read this line again. It says, “I realized today that a good life free of this addiction is better than a good feeling that only last momentarily.” So much wisdom in that sentence. Amazing. So much wisdom. That is true for all of us. Isn’t it? So true for all of us in that we just-- the real living we want, the real pieces on the other side of that hard thing. So, so true. Thank you so much, Anonymous, and thank you so much to Maggie Paulson for that amazing review. 

Ep 297 Can you hold yourself accountable without being self critical Your anxiety toolkit

All right, folks, here is something I want to first start with. So, we’re talking about, can you hold yourself accountable without being self-critical? That’s a really important question because, and the reason it’s so important for recovery is, unless you’re in an intensive treatment center, where you have services 24/7, chances are, you’re doing a lot of this hard work. You’re doing a lot of these “hard things” on your own. And in order to do a hard thing, you do have to be accountable. You have to generate. If you could see me, you can see me like my arms are moving like cogs are turning. You have to generate motivation to do these hard things, because the truth is, no one wants to do these hard things. That’s why they’re hard. I don’t blame you if you don’t want to do hard things today because hard things suck. I keep saying that lately and I mean it. It’s hard. I don’t want to discount and make this podcast out to be like, “Oh, it’s just easy. Just do these five mindful things and you’re going to be fine.” No, it’s hard work. You have to generate motivation and you have to generate accountability. The accountability is what gets you to do it, even though you don’t want to do it.

And here is the point I want you to really take from this episode. Hopefully, this is a shorter episode, because I know I’ve been going a little longer lately. I’m a bit chatty. I’m chattier lately. I don’t know why. Here is the point. Being accountable is not synonymous with blame and harsh treatment. So, let me put that same concept into different words. Holding yourself accountable doesn’t mean the same as blaming yourself, beating yourself into doing the thing that you said you were going to do. That’s not accountability. Accountability is just holding yourself accountable to do the thing. Saying have some accountability doesn’t mean treat yourself terribly. And as I was saying at the beginning, I had heard something and I don’t even remember where. I’m assuming it was on Instagram. They were saying like, “Don’t tell me to be accountable. That’s just mean. That’s just mean that you would ask me to be accountable.” And I’m over here going, what? No, hun, someone somewhere you’ve picked up the idea or someone’s taught you that accountability means getting whipped and that isn’t true. That’s not true. 

Accountability, we just last session, last episode did 196. It was about, what is your recovery goal? So, we got really clear about what do you want your life to look like. If you haven’t listened to that, please go back and listen to it. So, we got really clear on that. And accountability is saying, I love myself so much, and I love those recovery goals so much that I’m going to do this thing. That’s accountability. I value my well-being so much. I value that goal that I want for myself. I believe in myself so much that I’m going to do that thing. That hard thing. It’s not whipping and beating. It’s not mean words. It’s not saying get off your butt your lazy thing. That’s self-criticism. That’s not accountability. That’s just bullying. That’s self-bullying. 

And so, what I want you to look at is, accountability is simply saying, I’m going to do the thing I said I’m going to do because I deserve it. I deserve the outcome, the dream, the goal, the life that lines up with my values. Accountability isn’t saying, push through no matter what, no matter how much pain you’re in, just like plow through it. Believe me. I’ve been there. I’ve been there. Sometimes you have to do that. I’m not going to say that that’s particularly even wrong because sometimes we do have to push through, but you don’t have to be mean. And it’s asking yourself, how willing am I to show up and do this hard thing so I can get this goal? Exactly like Anonymous said in this “I did a hard thing” segment. That’s accountability. Everything that Anonymous said is accountability. I should have actually-- sorry, Anonymous. I should have just read your “I did a hard thing” and said, “There you go, folks. That’s the episode. That’s what accountability looks like.”

So, it’s accountability. Compassionate accountability will still get you across the finish line. Often when I talk to clients about roadblocks to self-compassion, they’ll say, “Well, I won’t get up and do it if I don’t beat myself up.” Is that you? Maybe I should ask that question. Does that resonate with you? Like, “I won’t get to the gym. I won’t exercise. I won’t do the exposure unless I beat myself up. That’s the only form of transportation to get myself to do the thing.” 

If that’s the case, please make today the day that you start trying something else. I’ll tell you why real quick and then I’m going to finish up. Yes, there are times when being self-critical gets you to do the thing. And if that’s what it takes, it’s up to you. You get to choose. I’m not going to tell you what’s wrong. I’m not going to tell you you are wrong. I don’t want you to feel judgment about that from yourself or from me because we’re all doing the very best we can with what we have. So, that’s totally fine. But if you use that as your only way, the chances are, eventually, it’s going to burn you out. You’re going to start to feel so bad about yourself that you will give up. We’ve got all the research and science to back it. 

So, it’s only short-lived. This is only going to work for a certain amount of time until it stops working. So, let’s use today to try something different. Let’s put eggs in different baskets. Let’s practice compassionate accountability. 

Again, I’ll say it, compassionate accountability is doing the thing that you set out to do, because you love yourself and you love your goals so much that you’re willing to do the hard thing. That’s it. That’s it, friends. That’s all I got to say. 

All right. I love you. Have a wonderful day. I just love you. I’m squeezing my fist. I just love you guys. Thank you for being a part of my community. Thank you for supporting me. I totally understand you have gazillions of options for podcasts and gazillions of people who are probably doing great things. Thank you for letting me be a part of your journey. It’s an honor. Really it is.

Have a wonderful day.

Aug 5, 2022

In This Episode:

  • The importance of having a specific recovery goal
  • Why you need a recovery goal in order to gain traction with OCD and other anxiety disorders 
  • What does your “recovery dream” look like? 
  • What is getting in the way of your recovery goal? 
  • Learn to live your life “as if” you had already reached your recovery goal. 

Links To Things I Talk About:

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. 

Spread the love! Everyone needs tools for anxiety...

If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

EPISODE TRANSCRIPTION 

This is Your Anxiety Toolkit - Episode 296. 

Welcome back, everybody. I am so fired up for this episode. Oh, I just love this stuff. I love it. I love it. I love it. 

Okay. Let’s get started. First of all, let’s do an “I did a hard thing.” This one is epic. This one is from Fisher and they said: 

“I have OCD, health anxiety, and panic disorder. And last year, I was diagnosed with POTS,” which is postural orthostatic tachycardia syndrome. That is the chronic illness that I have also. And they’ve said: “This was very overwhelming for me. I was petrified of exercising because of the exercise intolerance that comes with POTS and worrying that it was a life-threatening cardiac issue.”

Oh, I am with you, Fisher. So, for those of you who don’t know what exercise intolerance is, it’s like it’s almost impossible to do exercise. When you stand up, you pass out. And when I’ve been triggered by POTS, it’s hard to even do a block around, walk around the block of my house. 

“My doctor did all the cardiac tests to rule out any underlying issues before diagnosing me with POTS and recommended cardiac reconditioning to help me get started with recovery. My first barrier to overcome this was to trust in my physician and their diagnosis and follow their recommendation for exercise therapy. My second barrier was facing my fear of exercising. I can now say that I’m in my last week of the program after going twice a week for three months, along with exercising on my own at home. It’s been a struggle. There are some days where I flare up.” I hear you, Fisher. I totally get you. “And it seems impossible, but accessing self-compassion, budgeting spoon usage for the day, and moving things around to allow myself to rest have been invaluable tools to help me with the experience. A wise person told me after my diagnosis, the only predictable thing about living with a chronic illness is that it is unpredictable. So, I try to accept that uncertainty as a part of my life, living with anxiety and POTS.”

Fisher, I just love you. You’re killing it here. “I have a lot of work to do in learning to live with my chronic illness and my OCD and health anxiety recovery, but I make a little progress each and every day. P.S. Would you consider doing an episode on coping with chronic illness that mirror anxiety symptoms like POTS? I’d love to hear the skills that have helped you and some of you recommend coping strategies. Thanks for all the hard work that you do on this podcast.”

Fisher, I would love to have you on the podcast. I am going to write it in my notes to reach out to you because I think this is such an important topic, one that I myself have gone through, and thank you for writing this. You are doing badass, amazing hard work. So, yay. Thank you. You will hear from me. If you don’t hear from me, reach out, because I think that would be wonderful. 

Okay. Let’s take a breath because that brought up a lot for me. I just feel such deep compassion for Fisher and all of you who are just doing the hard thing. So, so cool. 

All right. Quickly, review of the week from Mosley23. They said:

“I’ve been listening for several years and can say that this podcast has helped immensely to understand my OCD and anxiety. Kim and her guests have provided very helpful ideas, strategies, and encouragement that have been so key in helping me to get to a good place with my mental health. Could not recommend it more highly if you or someone you love have an anxiety disorder.”

Thank you so much, Mosley23. Your reviews mean the world to me. The world really. Really, it’s so helpful. And again, if you give a review, and I know specifically what episode you’re talking about or what specific thing, it means then I can do more of that and help more people. So, yay. 

296 What is your recovery goal Your anxiety toolkit

 

All right. Let’s talk about recovery. It’s taking all of my energy not to bang my hands down on the table and be like, “Let’s do it.” 

All right. So, I take walks every morning and I often listen to podcasts or audiobooks. I’m a big self-help, non-fiction kind of gal. And I’m often listening to these most motivating speakers and it gets me so fired up. This morning, I got so fired up because this is such a part of the work of being a clinician. We get trained on all the theory and the statistics and the diagnoses, but we don’t get taught very well how to help a client identify what is your recovery goal. What are you here for? And so, even though you, listener, loving beautiful person, human friend – even though you’re not here for therapy, because this is not therapy, I want you to be really intentional about your recovery goals. 

Why is that important? Because, when you’re dealing with a mental health issue, you’ve already got a full-time job. You’re working your butt off to manage that. And sometimes we can put our attention so much on the disorder instead of making time and carving time and having a mindset towards, what do I want life to look like once I recover and how can I use that recovery goal to fuel the work I’m doing now while I’m in the trenches?

So, what I’m not saying here is, list off 20 magical things that will happen to you in the future when you get rid of your anxiety disorder, because that just means now you have an additional list of things to check off and it’s overwhelming and anxiety producing. So, I’m not talking about just lists. I’m talking about getting clear on what you want life to be like, even if anxiety is there. 

So, let me ask you. You guys know, I love questions. First question, what does your recovery dream look like? What do you wish it looked like? So, often when I ask that to clients, their first response is, they put their hand on the buzzer and they’re like, “Pick me.” I don’t want anxiety and I don’t want that to be your goal. So, the absence of an emotion is not a recovery goal. We need anxiety. If you didn’t have anxiety, you’d put your hand on the hot plate. You’d jam your hand in the door. We need anxiety. So, try not to make that your goal. I’m talking about specifically, zoom in and imagine that you are the ring camera on your house. What would be happening in your house, around your house, around your life? How would you be interacting with the world? That’s the stuff I’m really interested in knowing. 

So, for me it’s like, okay, if I was in my fullest recovery, I would be with my kids. I would be helping my clients and my listeners and my followers. I would be a connected wife. I would be a wife that shows up for my husband, even when it’s tough and we’ve got stuff to work out. I’d be someone who still has good days and bad days. But the bad days I just keep showing up, like it’s a beautiful day to do hard things. I’d be that person. I’d embody “it’s a beautiful day to do hard things.” That’s what recovery would look like for me. It might not be that for you. And please don’t just use mine because mine is just for me. Make it specific for you and look at that, write it down. Because in those answers, in those questions and answers is all of the details in which you can start to implement today. 

So, example being, if that was my recovery goal, what can I do today? I can get down on the floor and I can play with my kids, even if anxiety is there. I can go to my husband and say, “How are you? How are you really?” And practice staying in the moment and practice listening instead of letting my anxiety do all the talking. I still do the talking, but I’m listening to my partner, not to my anxiety. I’m practicing this and it’s not perfect. I might even suck at it. That’s fine. But I’m already working towards the recovery that I want, the life that I want, the dream that I want. 

While I have anxiety, and if it’s there, I’m also going to bring myself into intention that my goal was to help people, to be of service, to show up for you guys and have a couple of giggles and be myself because that’s a huge goal for me, to be more myself, which means I have to share a few layers of professionalism and just show up as Kimberley, the imperfect, giggly, silly, goofy, all-over-the-place Kimberley. So, I’m working towards that, whether anxiety is there or not. And by practicing that, I’m already 20 steps towards the recovery goal because I got down-dropped into what was it that I was looking for? So, this is the work, guys. Don’t use this recovery list as a list of expectations that you tell you, you won’t ever get to. Instead, use it as a way to implement it today. 

Now, what I just said is the perfect segue into identifying the next question I had in my prep for this. Are you living according to old stories or your recovery goal? Because often, if we’ve made mistakes in the past or we’ve struggled in the past or we have messed up in the past, as we’re engaging with our goals, we’re telling ourselves a story. What’s the point? Look at that, what I wrote down. Like, I want to show up for my followers and listeners. I want to be a wife that’s engaged and connected. I want to be a mom that’s on the floor playing with their kids. I want to be a therapist that is just pouring my heart into the people. So, that’s my list. 

But if I’m living according to old stories, I’d go, “Yeah, that’s not going to happen because you totally screwed up with that one client that time, and you totally said something inappropriate to that one person and offended them and harmed them.” And so, you’re just, “Nah.” You think you don’t deserve to have that recovery or it’s just not possible for you, Kimberley. That’s what we call a fixed mindset. You’re living off of old stories. “No, I couldn’t do it in the past. I tried. So, there’s no point. There’s my recovery list. I’ll never get there.” That’s old stories. 

And the whole point of me talking with you every week on doing the “I did a hard thing” segment isn’t just because-- well, yes, it’s because I love it. I ain’t going to lie. I love it so much. But the whole point I do that is so that you guys can see baby steps lead to medium size steps, leads to large steps. And you mess up and you totally screw up. I’ve done whole episodes about this in the past. Just recently actually. You mess up and then you go, “Okay, I’m going to just do one more.” It’s going to try one more time, and one more time. The whole AA approach, if you have an addiction, if you go to alcoholics anonymous is one more day. And there’s some research around that model because it helps you just to stay in the short term, doing today, not looking at the long term, and changing the story. 

The next question I have is, are you really clear of what recovery will look like, and does that line up with your values? The reason I ask that, and that’s the final question of this episode, is when I ask my patients like, “Okay, let’s get a recovery plan together. What are your treatment goals? What do you want to look like once therapy is done? How would we define that?” Often, because they’ve been trained and conditioned from society to be this, they’re like, “Okay, so I want to have a house and I want a car and I want to have 100,000 followers on Instagram and I want to be a size blobbidy blah.” And it’s just like, whoa, whoa, whoa, whoa, whoa. Is that what society told you or is that actually what you want? Do you actually value those things? Are they coming from a place of getting other people’s approval or are they coming from a place of what really feels good to you, really feels good? What feels true to your values? Because yeah, it’s easy to say, “I want to have this many dollars in the bank,” or “I want to have achieved a certain thing.” That’s fine. I’m not against that. In fact, I love that kind of thing. I love goals. But I first want you to ask yourself, why? Why do you want that goal? Is it because you want approval or is it because you want to prove you’re worth? Because if it’s any of those two things, it’s probably going to be a painful process. Because, number one, you won’t get approval from other people that’s long-lasting because that depends on their mood and their values themselves, and you won’t get up to a place where you feel worthy because you’ve based that on a conditional relationship.

The only way we can actually build self-worth is to drop all the conditions and recognize that you’re worthy right now, whether you reach this goal, this recovery goal or not. It’s not a condition. The thing to remember here is your worth doesn’t go up if you reach these goals. Please remember that. Your worth is the same whether you reach them or not. You’re a valuable, important human being that deserves love and kindness. So, just keep an eye on that. I’m sorry, I’m going on a little tangent there, but it’s so important as you embark on getting really clear. And I really want you to be really, really clear. I really do. 

I’ll use a really ridiculous example, and mind me, I understand that this is a very privileged example, but my daughter is going off to middle school. She’s going to a school that’s very far away. And so, I have to engage in a carpool. We have a four-wheel-drive that we use to do all of the outdoor stuff that we do. So, I need a bigger car to fit seven people. And so, I’m trying to get really clear on values as I buy this car. I understand this is a ridiculous example, but let’s use it as an example. As I go to buy a car, what do I want to feel when I get in the car? What are the things that matter to me? Is it the brand? Do I have to drive a Mercedes Benz or is it the functions? Is it the way it makes me feel? Is it the color? Is it the way my kids feel? That will help me to make a decision. So, I drop down into, really what do I want? What’s important to me? Is it important for me to have technology or is it important for me to have ease? Is it important for me to have technology or pay less for this car? And so, it’s asking questions. Don’t go overboard here, but asking questions so I get really clear on what matters to me, what values matter in this decision. 

So, again, I get the ridiculous privilege of that whole question, but they’re the questions I want you to ask about you, because you deserve that. When you make decisions about your recovery and your life, you want to ask the questions that are detailed so that you can pivot in those areas. It doesn’t have to be perfect, but get clear on what you want recovery to look like. Because if you don’t, you’ll probably find that you’re wavering around feeling directionless, not sure why you’re doing all these hard things, feeling like, what’s the point really? But when you know exactly what the outcome you want is, you’ll know exactly the point. 

Okay. I love you. I love you. I love you. I love you. Thank you for being here. It is a beautiful day to do hard things. I hope that was helpful. I will talk to you guys next week, and have a wonderful, wonderful, wonderful, wonderful, wonderful day. By the time you hear this, I’ll be back in the United States from my trip. If you want to go back and listen to the old episodes, I encourage you to do that. All the goodness is right there in those early ones. 

Have a wonderful day, everybody. Talk to you soon.

Jul 29, 2022

SUMMARY:

Today we talk all about how to manage when your fears appear in your dreams.  This was a heavily requested topic, so I hope it was helpful for you.

In This Episode:

  • Why our fears and obsessions show up in our dreams
  • What to do when your fears appear in your dreams 
  • How to manage the distress when dreams feel “real” 

Links To Things I Talk About:

ERP School: https://www.cbtschool.com/erp-school-lp

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. 

Spread the love! Everyone needs tools for anxiety...

If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

EPISODE TRANSCRIPTION 

This is Your Anxiety Toolkit - Episode 295.

Welcome back, everybody. It is Episode 295, which sounds like a whole lot of episodes. It really, really does. Actually, it shocked me when I saw that number.

Today, we are talking about when your fears show up in your dreams. I would say quite regularly, actually, a client, particularly morning clients will often say like-- I’ll be like, “How are you? How was your week?” And they’ll say, “Well, I’m just feeling really overwhelmed. I had the most bizarre dream last night and it’s hard to shake it off.” And so, I’m wondering, I’m guessing. I’ve had this experience, I’m guessing you have too. And I wanted to talk this episode about how we might respond to that situation and what we need to look out for when we have this situation, particularly if you have anxiety. That’s really the specific group of humans we’re speaking to today. And I’ll share a little bit more about that as we get going.

All right, before we do that, let’s do the review of the week. This one is from FullWalrus and they said:

“I found this podcast by Googling an issue I was having, and this just popped up.” FullWalrus, this makes me so happy. Thank you so much for Googling this and finding me because that means we’re doing a good job at being on the internet and helping people in that way. “I had kept away from podcasts about mental health in fear of being triggered or being told I was crazy after all, and that didn’t happen obviously. Kimberley is a gifted presenter and a therapist who introduced me to Buddhism and mindfulness in a way I’d never thought of before. For the first time, I feel like I actually have the tools to help me manage OCD, and this show is sure a beautiful compliment to any therapy you should be currently undergoing because we all need therapy. Thank you for everything, Kimberley. My life is forever changed and I am forever grateful.”

Thank you, FullWalrus. What a wonderful, wonderful review. I just love hearing how I’m helpful. I love hearing what episodes are helpful and it’s really cool that I’m a really-- I love Buddhism. I find it to be exactly what I need every time I’m in a hard time. So, I’m so glad that I’m bringing that in a way that isn’t overwhelming or overpowering. So wonderful, wonderful, wonderful.

This week’s “I did a hard thing” is coming to you from Holly. Holly says:

“Last week, I went to court to obtain full custody of my son since his father has become a threat to him. This was extremely difficult seeing as we have been in an abusive past. My anxiety was the highest it’s been in a very long time, but ultimately, I knew I had to take action. I did my hard thing and I couldn’t be more proud of standing my ground and not succumbing to so many fears.”

Holly, sending you so much love. This is 100% doing the hard thing. It’s so hard, because often we’re talking about irrational fears and so forth, but I love that you brought like I’m doing this real thing. This real thing. And I love when you guys share with me both you’re facing your fears related to your disorder, but also just facing fear about showing up and living according to your values and showing up for your family. And Holly, just so good. Thank you so much for submitting that “I did a hard thing” for our “I did a hard thing” segment.

295 When your fears show up in your dreams Your anxiety toolkit

Okay. Let’s talk about dreams. So, again, often people will bring to my attention like, what do I do if my fears show up in my dreams, or even fears you didn’t have right. Like fears that you never considered during the day, but once you go to sleep, it gives it to you, sucks it to you, and whatnot. So, what do we do in this situation?

Most people will report they wake up in a massive ball of sweat, high heart rate. It feels so real. It feels like it actually happened. And it takes some time for that to burn off. It really, really does. Some people say it even takes the whole day to burn off. And so, if that’s the case for you, you’re definitely not alone.

Now, one thing to think about when we’re thinking about dreams is we’ve been fed this belief that dreams are like windows into our soul and that they must mean something, and that some people interpret dreams. In fact, I’ll tell you a story. I’m a clinician, I’m a CBT therapist. I use science-based treatment methods. And I do remember looking for a therapist several years ago actually and asking some colleagues. And one colleague, who knew me really well, referred me to this dream analyst. And I went for the first session. I was like, “This is not going to work for me,” mainly because of exactly what I’m going to tell you.

Now, if you like dream analysis, 100% no judgment. The reason that I had a strong reaction to it is I was going through a very, very anxious time, and I knew that if I engaged in that behavior, it was going to trigger me in ways that I’ll share here very soon.

The way I understand and the way I was trained and the way I’ve researched dreams is dreams, are just thoughts you have at night. So, if you’ve listened to this podcast, you’ll know that during the day, if you have a thought, I’m probably going to tell you, thoughts are thoughts. Don’t give them your attention. Don’t give them too much kudos. And so, dreams are no different. They’re just thoughts that you have while you’re asleep, and do your best not to give them a ton of importance, a ton of weight, a ton of value, because when you do that, you can get in trouble, particularly if they’re anxious thoughts.

Now, let me say here, I am notorious for having the weirdest dreams. My husband often, when we first got married, would sit up in the morning and be like, “Tell me everything you dreamed,” because I dream about like, I once had this dream about turtles and we went scuba diving together. And me and these turtles, they were like cartoon turtles. We’re like going through these tunnels together. Ridiculous stuff. I’ve had dreams of going hot air ballooning with a giraffe, and I have had this dream many, many, many times. I would say tens of times. And so, yeah, sometimes dreams are just silly and crazy. But where they’ve got fear attached or danger attached or catastrophes attached, it can be really hard for us to not get caught up in them.

So, the next question is, is it effective to interpret our dreams? My opinion is there’s nothing wrong with it, but here are the things to look out for. If you have a dream and it’s attached to your obsession and you’re interpreting your dream, it’s a chance that you’re doing compulsions to try and get certainty around that obsession. So, if you’ve already got the fear and the obsession, interpreting the dream actually maybe just reinforcing the fear, giving it too much importance, giving it too much value, and therefore feeding you back into a cycle where you’re going to keep having more of them, and you’re going to keep having anxiety about them, because you’re responding to them as if they’re important and dangerous.

If they’re just random like you wake up, often people say, “I had a dream that a loved one died,” or “I had a dream that a loved one was in an accident or it was my fault or so forth.” If you have that, what I would encourage you to do is look at it curiously. For me, it’s either like a really silly cartoon style dream or it’s that I’m responsible for something, which just is a sort of, if I’m curious about that, I’m like, yeah, that makes sense. I tend to be hyper-responsible. I tend to take responsibility very seriously. So, that makes sense. But I’m not going to go and dig around more than that because now I’m digging around in the content of my fears and giving those fears way, way, way, way too much attention. Way too much attention.

So, is it effective to interpret your dream? It depends. And I will say really clearly, if it is around your obsession, I strongly discourage you from doing it with one caveat, with one exception, which is unless it’s for the purpose of actually doing an exposure that’s scary. So, that would be the one time I would say, yes, it’s cool to interpret your dream. If you’re doing it on purpose in effort to actually induce the actual obsession and fear that you have so that you can practice tolerating the uncertainty and you can practice writing that wave of discomfort.

We can and we do do exposures to the content of your dreams. So, again, if a client has a dream or you have a dream and it’s triggering you, whether it was a part of your old obsession or just a new one, you can choose if it’s really bothering you to do an exposure. You could do an exposure with imaginal exposures. We cover imaginal exposures in ERP School, which you can go and find out about at CBTSchool.com if you’re interested. ERP School is our online course that teaches you how to apply ERP to your obsessions.

So, you could do an imaginal exposure where you write a story about your worst fear coming true and the consequences of that, and you read it over and over and over and you just allow the anxiety to rise and fall. You could do that. Or let’s say if it’s a fear like, not long ago, I had a dream about this one area of the corner of my kid’s school. It was like this really bad thing happened. So, if it’s really bothering me and I’m struggling with reducing my mental compulsions about that. Yeah, I might go into that corner and just sit there and read a book or just wait there for my kids or whatnot. So, yes, you can do exposures to the content of your dreams, particularly again, if they’re really strong, repetitious, and they seem to be persistent.

What we can do in addition to that is apply a ton of mindfulness to the dream content itself. So, this is what this would look like. You wake up, whether it’s from the morning or from a nap. You’ve had a dream. It’s really overwhelming. It feels really real. It might even feel like you’re actually in the moment of this catastrophe or this event. And even though it feels real, we’re actually just going to be mindful of that.

Now, what does mindfulness mean? Let’s do a quick recap. Mindfulness is being present with what’s actually happening. So, within that moment, what’s actually happening is things feel unreal, things feel strange, things feel scary. Your heart might be beating faster. You might be sweating. You might have a tummy ache. So, that’s what’s happening. We’re present with that, but we’re also present with what else is happening. Oh, the birds are chirping. I feel my pajamas against my skin. This is the taste of the coffee I’m drinking. I can smell the coffee as well. We’re just being very mindful of what else is happening, and we’re doing all of that nonjudgmentally.

Key point: We’re doing all of this. We’re having the weird feeling. We’re having the anxiety. We’re smelling the coffee. We’re feeling our feet against the floor and we’re practicing not judging these things as good or bad, even though they might be uncomfortable. When we are acknowledging that they’re here, we’re allowing them. We’re being willing to experience them, not pushing them away, and we’re practicing being non-judgmental.

Now you may need to do this, and this is often our clients will say, “Yeah, I did that, and then it kept bothering me.” And I’ll say, “Well, did you do it again? Could you do it a little longer?” And they’ll go, “Yeah, I did. But then it kept bothering me.” And I’ll joke with them. I try never to be condescending, but I’ll say, “But did you then do it again? Did you keep going?” And that’s the key to mindfulness. Mindfulness, we don’t do these behaviors to make the discomfort go away. We do them moment by moment, minute by minute, 10 seconds by 10 seconds, just to practice being in the presence of this discomfort and giving the discomfort zero of our tension.

Now, the other thing we may want to do here is activate a behavior. So, if you’re feeling totally overwhelmed, totally anxious, everything feels like it really actually happened. A lot of clients will say somebody died in their dream and they actually cry and they’re experiencing grief as if it actually happened. That’s true too. That often happens. We would engage in behavioral activation of going, “If I didn’t have this feeling, what would I be doing?” Such a good question. If I didn’t have this experience, what would I be doing? And go and do that thing.

So, if I didn’t have this dream, I’d be getting up and I’d probably go for a walk or I’d sit down and check my emails or whatever it may be. Make sure you do those things and try not to divert away from the behaviors you would’ve done had you not had this dream. That’s the response prevention piece. If you didn’t have this dream, would you be giving this content your attention?

So, let’s say I had a dream about my child dying, which is devastating, the idea of it. So, when we say I wake up and I feel like it actually happened, my body is telling me it actually happened, even though maybe my child is right in front of me. Then how do I engage with the rest of the day? Am I ruminating about ways to prevent that from happening? Am I actually implementing behaviors to prevent it from happening? Because if I’m doing those things, I’m actually doing compulsions. I’m trying to solve a thought that I had, not an actual thing.

And so, this is why this is so important that we understand that dreams are just thoughts you have at night or during sleep. That doesn’t mean that they’re important and they need to be analyzed and that it’s a sign of something to come, because we wouldn’t do that with an intrusive thought. We’re learning not to do that. So, when we have a thought, we’re learning not to go, “Oh my gosh, that must mean it’s a sign.” We’re learning to undo that reaction and going, “Yeah, thoughts are thoughts.”

So, this is how I want you to maybe consider changing your response to dreams, especially scary dreams. Again, let me be really clear. If you love analyzing dreams and you find it helpful and you don’t find it loops you back into the anxious cycle, wonderful. No problem. I’m definitely not against dream analysis. But for those folks who were anxious, I just want you to know this information, keep it in your back pocket, or maybe even your front pocket for the times when you catch yourself engaging in behaviors that become ineffective.

My word of 2022 is “effective.” I have it written everywhere. It’s a huge part of the decisions I make every day, every minute. Does this keep me in being effective? And so, it’s such a great question when we ask ourselves, is this behavior effective? It won’t always be, you don’t always have to be effective. But sometimes again, when you catch trends that are getting you to be ineffective, we want to see if we can make a change. Okay?

So, that’s Episode 295: When your fears show up in your dreams. I hope it was helpful. Do not forget, it is a beautiful day to do hard things. This work is not easy, friends. This work is actually-- let’s just be real. This work sucks. It really, really does. It’s exhausting. It’s hard. It’s taxing. It beats you down. So, please be gentle. It is a beautiful day to do hard things. Please remind yourself of how brave and strong you are because you’re stronger than you think. And I will see you next week.

Have a wonderful day.

Jul 22, 2022

SUMMARY: 

Correcting thoughts can but a very helpful tool to use when you notice that you have lots of thought errors.  However, in some cases, correcting thoughts can become a compulsion.  In this episode, ask the question, “Can correcting thoughts become a compulsion?” And review what you can do to make sure you are not engaging too much in the content of your thoughts. 

In This Episode:

  • How to correct your thoughts and how this can help people who have errors in their thinking
  • How to determine when it is helpful to correct your thoughts 
  • How to determine when correcting thoughts is becoming a compulsion

Links To Things I Talk About:

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. 

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EPISODE TRANSCRIPTION 

This is Your Anxiety Toolkit - Episode 294. 

Welcome back, everybody. What a special treat to have you here with me today. 

Today, we are talking about when correcting your thoughts, we call it cognitive restructuring in therapy – when you correct your thoughts, when does that become compulsive? Or we could also say problematic. And so, we’re actually going to go into this today, and then I’m going to let you decide for yourself what is helpful and what’s not. But I hope today is really helpful. It’s a very, very, very important topic. It’s often one of the biggest mistakes therapists make, particularly those who are not trained in anxiety disorders and OCD, and ERP. It’s probably one of the biggest mistakes that they make. So, I want to really review this so that you can have the information in your back pocket and you can make the decisions for yourself.

Before we do that, let’s first do the review of the week. This is from Cynthia Safell and Cynthia said:

“I first was introduced to Kimberley’s clear and compassionate teaching style when I took the ERP school course for therapists.” This is wonderful, Cynthia. So, for those of you who don’t know, we have ERP School, which is a course where I teach you exactly how I would do ERP if you were my client. And then it turned out that a lot of therapists were taking this course. And so, we duplicated the course and I added a whole bunch of modules for therapists, so they can become excellent therapists for people with OCD as well. So, I am so delighted that Cynthia has written this review. She goes on to say: “In the past 3 weeks since taking the course, I recommended both the course and podcasts to my clients. So helpful. Thank you, Kimberley.”

Wow, Cynthia, literally, that is the biggest compliment. Really, it is. If a therapist can trust me so much that they would recommend it to their clients, that is the biggest gift to me. And thank you so much for telling me that, because it just brings me so much joy and so much pride. So, thank you so much, Cynthia, for that amazing review. 

Alright, before we move on to the bulk of the content of this episode, we also want to do the “I did our hard thing” segment. This is from Abby and Abby is over here doing some hard things. So cool. Let’s go. It says:

“I have come on holiday. I’m terrified of flying. My anxiety was high. My thoughts were racing, but I did it.” So good, Abby. “I got on the plane and I got on holiday. It was scary, but I did it and I’m proud. Now to commit to the holiday first two days have been hard, but sitting with it and not letting it ruin my time.”

Abby, this is so good. Not only did you get on a plane, but you’re doing all the hard things in addition, and that’s so good. What a treat for you. What a reward for you. You did the hard thing and now you’re on vacation. Isn’t that so cool? Thank you so much, Abby. And thank you so much, Cynthia, for being an amazing part of our community.

Alright. So, let’s get down to it, shall we? So, I am a cognitive behavioral therapist. I love cognitive behavioral therapy. If you haven’t heard what that is, I’m assuming you have, but basically what that means is there is a cognitive component to treatment, which is focusing on your thoughts, and there is a behavioral component to treatment, which is where we focus on changing behaviors. 

Now, in some disorders, we spend a little more time on cognitions and a little less time on behaviors. And in other disorders, we spend a little more time on behaviors and much less time on cognitions. So, I think it’s important for you to know that it depends on your disorder on how much cognitive restructuring or changing and thinking we do. And so, the whole point of today is to explore, is your cognitive restructuring, is changing and challenging your thoughts helpful for you and your set of symptoms? And you get to make that decision. I’m not here to tell you what’s right or wrong, but I do want to give you some guidance. 

294 Can correcting out thoughts become a compulsion Your anxiety toolkit

So, first of all, the big question that my staff bring to me when we’re in supervision, and this was actually inspired by a conversation we had during supervision, was what is the role of correcting distorted thoughts in treatment? So, if someone presents to me a distorted thought, a statement, they might say, “I’m an idiot,” or “What’s the point? I only ruin it and mess it up anyway,” or “I always make mistakes. I never do anything right.” I as the clinician and them as the client may benefit by pausing the session and checking in with them in how true is that statement. Is it really true that you never do anything right? Is it true that you are an idiot? Could we challenge that and could we start to have you practice changing the words you use towards yourself? 

I am a massive, massive advocate for cognitive work because I think that in general, we walk around and we say a whole bunch of stuff that’s not true. I do it too. I actually have put-- in the last 18 months, I have put in massive amounts of time and energy into catching because I was finding I was saying a lot of sweeping generalizations like, “I feel terrible today.” Even though I didn’t feel well, it’s like, okay, I’m saying these words, “I’m so tired.” That was another big one I used to say every day. My husband would ask, “How are you, Kimberley?” “I’m so tired.” And it’s not that that thought was wrong or not true. I was really tired. But I had to check, is it helpful for me to keep saying this? Is there another way that I could maybe reframe this or present this or look at this?

So, yes, there’s definitely a role in challenging and correcting errors in our thinking. And so, it’s important that we first look at what is a thought distortion or a cognitive distortion, or a thought error. It’s usually any thought that’s, number one, not true or not helpful, or keeps you responding in a way that isn’t beneficial. So, again, the thought for me is “I’m so tired.” It’s true. Is it helpful? No. Does saying that actually make me feel a little bombed and a little down? Yes. Could I maybe replace it with something else? That’s up to me. There’s no right or wrong. 

I want to be really clear here in that when we talk about correcting thoughts, we are not saying toxic positivity, like, “Oh, I’m supposed to tell myself I feel fabulous because I don’t.” That’s not what this is about. We don’t do that kind of thing. We just make small little shifts depending on what feels helpful to you. 

So, let’s go through a couple of scenarios. Does correcting thoughts help with depression? Now, based on the research, the treatment for depression is actually really balanced in terms of doing 50% cognitive work and 50% behavioral work. These numbers I’m throwing out aren’t science-based, but just in general, I want you to think about like, yeah, you have to do both. You have to look at correcting the lies that depression tells you, but you also have to look at your behaviors and how can you engage in behaviors that actually make you more fulfilled and happy and not feeling down. 

So, yeah, with depression, we look at a lot of thoughts that are very critical, sweeping generalizations, we look at a lot of thoughts that discount the positive. I thought that’s like discounting the positive like, “Well, yeah, even though I got an A in that test, still, I’m probably going to fail my last year of college.” So, they discount the positive thing and they make another sweeping statement. So, we really want to make sure we’re correcting thoughts when it comes to depression. It’s really important because depression lies. 

Do we correct thoughts when it comes to generalized anxiety? Well, yes, we can. But this is where this topic is so important, is you want to be careful. If you’re spending a lot of time correcting thoughts, there’s always room to correct your thoughts about things. But if you find that you’re trying to correct your thoughts just to reduce or remove your uncertainty, then it’s likely that it’s going to get you stuck in a loop where you have to keep doing that thought correction in a somewhat compulsive way to feel good.

And so, what we want to do here is, yeah, we want to be mindful of our thoughts, and then we may choose whether we want to correct it or not, or whether we just want to observe that I’m having a thought. This goes for depression as well because mindfulness-based cognitive therapy is a huge, huge science-based treatment for depression. So, you’re going to see a trend happening here. So, we always want to observe the thought because it helps us to diffuse from the thought and see it in perspective. And then we can choose to correct it if it’s helpful in that moment. Maybe if you’ve never corrected it before, if it’s a new thought that it’s helpful for you to do a little thought work with. And then again, you’d still do the behavioral piece with generalized anxiety. So, if you’re having a lot of anxiety, you still want to work on not avoiding things and not seeking reassurance and not doing any self-critical behaviors, and so forth. 

So, yes, what I would say is there is some benefit to correcting thoughts. The main thing with this is as long as it’s not the only tool you’re using, because if it’s the only tool you’re using, you’re going to be putting in a lot of work, a lot of time of the day correcting thoughts, and that’s probably going to take you away from living the life you want. Several episodes I did a podcast about your recovery plan and what’s getting in the way. The truth is, if you can identify the things you want to be doing when you’re recovered, once you’ve done that, you can start implementing that right away.

So, I often will check in with myself because I’ve been doing a lot of work too. Okay, I could correct the thought right now, or I could just immediately throw myself into the behavior I want to live by. That’s according to my values. And then I make a decision. What would be most helpful? Should I explore this thought? Or would this be a wonderful time to do my paint by numbers? PS, I love Paint By Numbers. It literally got me through COVID. You have to try it. It’s the coolest thing and it’s so fun. But I ask myself like, do I want to just allow the thought to be there and go do the thing I love? Or would it be helpful for me to correct it? There’s no right answer. But if I’m trying to correct things that I’ve already corrected and that I already know the answer to, yeah, I probably am going to choose to do the Paint By Number, if I’m completely honest. I think that’s a more effective route. You are going to have to think about it and do a little cost-benefit analysis for yourself. 

Then we are going to move over here, and this is very similar. Does correcting thoughts help with obsessive-compulsive disorder? You can see a progression here with depression. Yeah, we do quite a bit of it. Generalized anxiety, a little less because it can sometimes be very repetitive. When it comes to obsessive-compulsive disorder, guys, you have to be very careful about correcting thoughts. Because if you’re correcting thoughts to try and reduce or remove your uncertainty, it will most likely, and I would probably go as far to say, definitely turn into a compulsion that will keep you stuck. Because remember, the treatment of OCD and obsessive-compulsive disorder often involves leaning into discomfort, leaning into uncertainty, leaning into doubt, leaning into tolerating whatever experience of uncertainty and discomfort that you have. 

So, here is what I say to my clients, and this is exactly what I said to my staff. One of my staff had said, “Okay, when do we correct thoughts and when don’t we then?” And here is the thing. If somebody is coming to me and they’re saying something that’s an error in thinking around their ability to cope with discomfort, I would 100% correct that. So, an example would be, if a client says to me, “I can’t handle my discomfort,” I will probably have them challenge that. I might even say, “How do you know? Could this be the first time that you actually do tolerate this discomfort or cope with this pain?” So, I would 100% challenge and correct thoughts around their coping. 

But if someone has a thought, “What if I have a panic attack?” the truth is, trying to correct that is uncertain anyway. You’re not going to be able-- you can’t say, “No, I won’t,” because you don’t know that. You can’t say, “Yes, I will,” because you don’t know that. So, only correct thoughts around your struggle to cope. Never correct thoughts where you’re trying to reduce or remove your uncertainty. That would be my best advice to you. 

Another point here is, if you find you’re correcting the same thought repetitively, chances are, it’s a compulsion or will turn into a compulsion. The reason that I push this so heavily is you’re going to-- here is where I really struggle the most, is you’re going to-- if you’re on Instagram, a lot of you come, listen, you follow me on Instagram. We have an Instagram account called Your Anxiety Toolkit. There are hundreds of accounts that tell you to correct every single thought you have, and I don’t agree with that. I do not agree with that. I think that that is terrible advice. Because number one, you could spend your whole day doing that, particularly if you’ve got bad anxiety or depression. Number two, you could spend your whole day doing the exact same behaviors you did last yesterday and last week that obviously didn’t reduce or remove your discomfort. And the third thing to remember here is we have scientific evidence specifically for obsessive-compulsive disorder, but also for generalized anxiety disorder, that most people who have these disorders, there is a certain set of things happening in their brain where cognitive restructuring just doesn’t stick. The part of their brain that allows them to correct things, there’s a weakness there or there’s this bad connection there, which means if this were to work, it would’ve worked already and they probably wouldn’t suffer because they would go, “Oh yeah, you’re right. That doesn’t make any sense.” And off they go. 

It’s really frustrating because I know a lot of you see your partner or your friend who can quickly correct a thought or quickly do a quick Google search, quickly get reassurance and they’re fine. They get to move on. But the brain of an anxiety disorder is different, specifically the brain of someone with obsessive-compulsive disorder is different. And so, for you, you might get a moment of relief, but then you find the thought comes right back. And so, again, there’s no real point you can. Doing it is like whack-a-mole. If you do it,then discomfort goes away and then it comes back and you do it again. And now you’re just stuck, like weeding weeds that keep growing. 

So, these are the things I want you to think about for yourself. I’m definitely not telling you what you have to do. Again, this is not therapy. But I want you to do a little inventory for yourself and just ask yourself what would be helpful and what’s not.

The last question I have here for myself is, when does correcting thoughts help in recovery? Just like I said before, if it helps you in terms of reducing your self-criticism, increasing your sense of mastery over a task, or increases your ability to feel like you can cope, well then, I think it’s a helpful tool. I’ll give you an example of that. 

I personally hate running payroll. Every month, I have these beautiful 10 and 11 staff. It’s actually more like 13, 14 beautiful staff who work for me. And at the first of every month, I have to run all this payroll stuff. And guys, to be honest, I suck at it. I’m terrible with numbers. I get all the numbers mixed up. It takes me twice as long as it would, but I really do value the importance of me knowing what’s happening in my business. So, I do it. I’m doing it. While I’m doing it, I have a lot of thoughts like, “I can’t do this, I don’t want to do this,” and a lot of like, “Ah, this is too hard” thoughts. 

So, in that situation, I’m correcting my thoughts so that I can embody a sense of like, “No, I’m a really good boss and I’m trying to run a business that helps other people with their life.” And so, I correct my thoughts so that I can embody like, “No, this is important. I want and I’m choosing to do this. This is important for my staff. It’s important for me to get it right. And it’s worth the time.” So, in that situation, correcting the thoughts is really helpful because it helps me with that degree of anxiety. However, if I was having thoughts like, “What if you make a mistake? What if you make a mistake? What if you make a mistake?” correcting my thoughts to like, “You won’t make a mistake or that’s not even true. So, it’s not going to be helpful.” 

So, again, let’s go back. When it will help is when it’s around your coping, when it’s around your capabilities. So, if you’re having a lot of thoughts like you suck and you can’t and you’re not good enough, you’re not strong enough, you’re not wise enough, you’re not courageous enough, yeah, you can correct that into more encouraging statements. But we don’t do it around uncertainties. We don’t do it around uncertainties. That will keep you stuck.

Now the last thing I will say here before we wrap up is, is there a difference between education, reassurance, and assurance? So, let’s just break that down. If a client comes to me and they say, “Oh my gosh, I keep having these horrible intrusive thoughts. Something must be wrong with me,” through the lens of education, I might educate them and say, “Listen, everyone has intrusive thoughts. You’re just like everybody else and you shouldn’t be ashamed. And I really want you to understand that having intrusive thoughts is a normal part of having a really healthy working brain.” I consider that education. And you deserve to get education around things. So, if you have, let’s say, a new illness, it’s okay to go and get educated about the new illness. That’s not a compulsion.

Now, there will be times where you educate yourself and you need to tweak what you know or learn something new, and that is also fine. The thing I would have you as we leave for this episode just continue to think about is the thing that we want to look out for is when it’s called reassurance, which is repetitive over and over attempts to reduce or remove a thought specifically related to your anxiety or your uncertainty. So, that’s the real thing I want you to think about and look out for. Take note. And the other thing I want you to remember is, please don’t beat yourself up if there are days when you do a lot of thought correction and it turns out to be a compulsion. You’re just a human being. There is no right or wrong. Often, I’ll say to a client, they’ll be like, “But what if I do correct a thought?” I’ll say, “You know what, you’re going to have ups and downs. So, try not to get too perfectionistic about this practice.” 

There’s just these general ideas and you’ll know in your body if you’re doing it compulsively. A great and easy way to know if you’re doing something compulsively is, are you doing it with urgency? Are you doing it with an experience of resisting discomfort in your body? Are you doing it to reduce or remove a thought that you’re having? And are you doing it repetitively? Those are things where if you’re doing those things, you will know you’re probably doing a compulsion. And in fact, I encourage you to get really good at catching those things because then you will be one step closer to recovery. 

Alright, my loves, that ends the episode on whether correcting thoughts is a compulsion or not. I’m going to let you really come to a conclusion on your own, or you can go and speak with your clinician and get to the bottom of that for yourself.

Have a wonderful, wonderful day. It is a beautiful day to do hard things, and I will talk to you very, very soon, aka, next week.

Have a good one, everyone.

Jul 15, 2022

This is Your Anxiety Toolkit - Episode 293.

You guys, I’ve totally screwed up. Oh my God, it’s going to be one of those episodes where I laugh a lot. Maybe not. Who knows? 

Alright, I totally screwed up. It’s funny because I have for months been thinking about doing an episode and reminding you guys mostly so I could remind myself that I’m a human being, that I’m going to make mistakes, and it’s one of the biggest lessons that I have had to learn over and over and over and over again. It’s really frustrating, you guys. I’m so frustrated by this fact that humans make mistakes. I don’t like it. It makes me mad. If only we could figure out a way where we don’t and we don’t disappoint people and we don’t screw up. If anyone has figured this out, let me know. Just shoot me an email, tell me your special secret, because I haven’t figured it out yet. So funny. 

Okay. Before we get into it, this is actually pretty much a coincidence and I love when big coincidences happen, but the review of the week is actually from Flashcork. They’re writing a specific review on Episode 193, which I think is really cool because this is by coincidence 293. And they said:

“This episode 193 is just what I needed to hear today. I’m stressed and anxious about my upcoming trip and experiencing racing thoughts. This will help me to manage those feelings and practice by shortening the leash.”

Now, if you haven’t listened to this episode, it is probably one of my most favorite episodes. A lot of my patients and clients have said that this concept has helped them a lot. And so, really go back and listen to 193. If you want to practice being able to be in a place where you can manage those thoughts a little better, go back and check that out. It’s just a metaphor. 

Flashcork says: “It makes sense because it has worked for me walking Sally, my Golden Retriever.”

I make a reference to thoughts being like a dog on a leash. So, you can go back and listen to that anytime.

That’s the review of the week. Thank you, Flashcork. So happy to have you join us. 

The “I did a hard thing” is from Allison. Allison says:

“I’m going to go on a job interview next week after applying to a different job, going through the grueling interviewing process and at the end not being successful. I’m working really hard to believe in myself, screw up my courage to attend this interview and be open-hearted about the new possibilities. It’s hard to pick yourself up and try again, but I’m doing the hard thing of trying again. I’m scared, but I’m proud of myself.”

Ep 293 I made a mistake Your anxiety toolkit

Allison, you are doing the work. And I’m actually going to take your advice today, Allison, because this is so perfect for the topic of today, which is like, yeah, sometimes we do screw up and we just have to get up and we have to try again. It’s so important. I’m so, so I’m impressed. I’m just so impressed with your courage and thank you so much for sharing that because I think we’ve all experienced it. 

So, Allison, let me tell you my hard thing. I want to preface this with, I think in my-- if I’m being completely authentic with you guys, I think that I’ve somehow, for many years of my adulthood, without me realizing, and in not a super severe way either, it was a very secret underlying compulsion I think I’ve been doing for years that I didn’t even know I was doing until the last couple of years is I was trying to find a way, constantly striving to find a way that I could live in a world where I didn’t make a mistake. Now I understand I’m a human. I don’t think I’m a superwoman. But in my mind, I think I’ve had-- well, I know I have, let’s be honest. I think in my effort to control my emotions that I’ve engaged in these little nuanced secretive behaviors of constantly trying to find the formula where I don’t upset people and I don’t screw up.

Let’s just take a minute because it’s funny for me to say that because how many times during the week with my clients and with you guys and everything I do is about self-compassion and letting go of control. And all along there was this nuanced little secret slither going through my life. And I think that number one, a part of this is true for a lot of people who have anxiety and are high functioning. Because I spoke to a couple of friends about this and they were like, “Yeah, to be--” when you have anxiety, to be high functioning, you have to put in place systems and procedures and routines to keep you going. And it makes sense that we often engage in other little behaviors that make us feel like we’re getting control when we don’t. 

Everybody knows, I even spoke about it a couple of sessions ago, that I am so in love with calendaring. My life has changed since I’ve been more intentional about my calendar. I’m not compulsive about it at all. Because I’m managing two children and two businesses and a chronic illness, if I can be really intentional and effective with my schedule, I can go into the day. I never worry about what I have to get done anymore. Really, I don’t. It was the best change I ever made because I have a system where I write down what I need to do and I throw that list out because I immediately calendar the times that I’m going to do it. So, I know it’s going to get done because it’s in the calendar. And if I don’t get it done, I’ll reschedule it. And I know I’ll get it done. And through the process, I’ve actually built such trust with myself. I know. I know I used to worry that I won’t get things done. I never worry about that anymore because I’ve gotten really good at this process. You guys know what’s going. 

This week is literally the only week of the year where the things on my calendar cannot be rescheduled because my beautiful daughter, who is a delight, she’s growing up to be this absolutely gorgeous human. I wish you could all meet her. She’s just so good. I know I’m biased, but she is just so wonderful. It’s her graduation. She’s graduating elementary school, you guys, and I’m going to have a middle schooler next year.

So, the one thing this year-- because I’m my own boss. I can schedule what I want. The one thing I can’t miss is her graduation. And last week, you know what’s going to happen here I was prepping to present at this conference and I got on the call and then we were doing this rehearsal and she said, “Okay, great. I’ll see you next Friday.” And I was like, “No, no, no, no. It’s the week after.” And she said, “No, no, no it’s next Friday.” And I’m like, “No, no, it’s not. And I’m always right. It’s in my calendar.” And she’s like, “No, it’s really not. It’s next Friday. You agreed to it on this date.” And I realized she’s right.

Now, I said to her, literally, “I cannot do it with this whole thing. I can’t do it. I’ve totally screwed up. This is not something I can reschedule.” And she was like, “Oh, okay.” So, she had to basically message a whole foundation. They had to change everything. They had to try and figure it out. This is where it was so humiliating, is they had to reach out to the person who was going after me, who is a very, very, very well-known person in the OCD community who I respect and don’t know. So, it’s like I have a relationship and had to ask him to reschedule his entire day because I screwed up. 

Now, I know this is not a huge disaster. This is in the grand scheme of things. This is not a huge problem, but I felt so bad. Oh my God, it was so painful. I was in this meeting and to see their faces of just pure annoyance and frustration and anger of like, “What? You got the date wrong?” They were very kind, but I could tell they were annoyed. 

And so, my question to you, because I love questions, is what do we do when we screw up? What do you do when you screwed up? 

Now you might be thinking this isn’t a big deal. I want you to think about a time when you did screw up that’s a big deal for you, and I want you to ask yourself, what did you do when you screw up? 

Immediately for me, this is the reason I wanted to really do this episode, is there was this interesting shift in me this time where-- because I haven’t screwed up this big in a couple of years. This was a pretty huge screw-up. I looked like a complete fall in something that was organized months ago, we’ve been talking about it, emailing back and forth. How did I miss this? I don’t know. But what was fascinating to me is, once upon a time, I would’ve said some very mean things to myself. Really, really mean. And I probably would’ve-- now that I’m noticing it is I would’ve responded, not just with self-criticism, but I would’ve tightened my belt even more with checking behaviors, rechecking, more controlling calendar, like compulsive calendaring. I would’ve overcorrected because I have been known to overcorrect. If you ask my partner, he’ll tell you I often used to overcorrect pretty bad. If I make a mistake, I would-- if I upset someone, I would go overboard trying to get them to like me again. Or I remember I used to-- if I was worried I offended someone, I would like to apologize over and over and over again. I don’t know if you’ve done any of these behaviors. You might want to gently say, “Kimberley, you’re not alone.” I’m kidding. 

But this time what? I notice this shift in me where I was like-- what I say to my son all the time is, “Oh my gosh, I’m such a ding-dong.” I’ll say you’re such a ding-dong and he’ll say you’re such a ding-dong. It’s a funny thing. It’s lighthearted and it’s not critical. It’s just like, “Ding-dong. You’re such ding-dong.” And what was interesting is I responded by went, “Oh my gosh, I’m such a ding-dong,” but it wasn’t-- I said things that sounded critical, but it wasn’t. There was this giggle to it. There was this acceptance of my humanness to it. It was so playful in my response. And I mean, this is a big deal for me because I very much value the respect of the people in my field and I work really hard to get their respect. Not in a people-pleasing way, but it’s a very big value for me. And it was funny. I just went, “Oh my gosh, I’m so sorry. I’m a ding-dong.” And then I said, “What can we do to fix it?” It was just a very transactional thing. Whereas before I would’ve, “Oh my God. I’m so sorry. I’m such an idiot. I can’t believe I did this. You should fire me.” I would just go overcorrect. 

So, let’s come here to the questions because I love the questions. If you’re driving, don’t do this. But if you’re not driving, I’d love for you to actually sit down with a notepad and just journal some of this out. So, when you screw up, what do you do? 

The second question is, is it okay for you? Because it was fine for me, and I want you to actually check-in, is it okay for you to make jokes about yourself? Answer it honestly. If it’s a yes, that’s okay. It can be giggly, nothing too harsh. If no, take that and really follow that out when you do make a mistake. 

Number three, is it helpful to apologize? Yes, of course. When we screw up, we should apologize. But how many times? And how do we apologize? Do we say it in a way that’s very factual, “I’m so sorry, this is a huge inconvenience for you”? Or do we say, “I’m sorry, I’m such a mess, screwed up person. I’ve ruined your day,” and make up a whole story about it? Because a lot of us do that when we screw up. Do you apologize over and over and over? 

Catch how do you respond to try and make it up to them. And that’s a really big one. Because if you find that you’re trying to make it up to them that’s okay. But are you doing it because it equals the degree in which you screwed up or are you doing it just to remove the discomfort you feel about the fact that you’re a human being? Make sure it’s in proportion. So, if you, let’s say, forgot to text somebody about something, you wouldn’t need to buy them a $100 gift card. That’s going overboard. Maybe it depends on the situation, but we’re just making an assumption here. If you forgot someone’s birthday. Well, yeah, you probably need to take them out for dinner and do make a big deal about it. But do you need to do that four times this month or throw them a party that puts you out of pocket? No. Don’t try to make it up to people in a way that actually takes away from your well-being. 

This is the next thing, is-- once I did this, I was really proud of myself. I’m not going to lie. I handled it pretty well, I think, and I was like, “Wow, I’ve made some pretty big growth in here obviously.” What was interesting is, once I hung up from them and I was like, “Oh dear.” I have all of these emotions, which I’ll talk to you here in a second about, I had to ask myself. The next question is, how long am I going to be on the hook for this, meaning from myself? How long am I going to hold myself on the hook? When am I going to let this one go? Because what I could have done is I could have said, “Okay, I made a mistake. It was not a good mistake there.” Obviously, I need to make some changes, but I’m going to beat myself up for the rest of the day. I’m going to ask yourself, how effective is that and is it in proportion with what happened, and is it effective? Really, does it make it less likely that you’ll do it again? The truth is, if I beat myself up all day, it’s not going to reduce the chances of this happening again, because it was a human mistake. And then the last question is, what can I do to resolve this if anything?

But let me come back to the emotions because those questions are very much related to these emotions. When you make a mistake and whether-- let me pose a couple of things to you. It could be something you do to somebody else. It could be something you do to yourself. Meaning if you do a ton of compulsions and you are up all night and now, you’re exhausted, or it’s any mistake you make. You had a huge panic attack and you left the party of your best friend and she’s really mad at you because you left her birthday party. It could be that you were depressed and you just couldn’t show up for your friend this day. So, there are so many ways in which this plays out. It doesn’t just have to be with scheduling.

When we upset other people or our behaviors impact other people, it’s normal to feel strong emotions. That’s normal. Often what we do is when we feel those strong emotions, we respond to them as if we need to squash them immediately, because we’ve told ourselves we can’t tolerate them. Guilt is probably one of the most common, shame being the second. There may be some anxiety related to it as well, or maybe some other emotions as well. But let’s take a look at those emotions and just quickly review how they may actually impact you. 

So, when we feel guilt, guilt is usually you’ve done something wrong, and I had done something wrong. So, guilt was an appropriate emotion. But I always think of guilt-- I’ve done episodes on this in the past. I think of guilt as just a stop sign to ask you, is there anything I can do to fix this now or in the future? Again, just really logical. In this situation, yeah, I can reschedule. I can be honest. I can do what I can to apologize. But beyond that, there isn’t anything else. And so, any residual guilt I feel from there, I must just tolerate. I must compassionately ride the wave of guilt.

Often, I see my clients, and I’ve done this myself, is if guilt is here, I’m going to beat myself up for it. No matter what, that’s the conditions. If guilt is present, I will beat myself up. And I want to invite you to have guilt and just be kind and let it ride. It’ll burn off like a candle. It’ll burn itself out and it’ll slowly dwindle away. 

Guilt is “I did something bad.” Shame is “I am bad.” If you do something and you screw up, and you feel shame, your job is to check-in and recognize that mistakes don’t make you bad. Literally, no mistake. There is not a mistake you could tell me of that makes you bad. Even if there was an absolute catastrophe that happened, mistakes don’t make you bad. You’re a human being. You’re going to make them. And I know, like I said to you, if you figured out how not to be human, please email me. I’ll happily take your email into my inbox and I’ll apply your rules. But the truth is, I know none of you are going to email me because it’s not possible and we have to accept it. We have to accept it. I’m just joking really about the email. 

And so, there is really no place for shame. If you feel shame, same as guilt, write it out compassionately. Give it very little of your attention. Don’t get into the content of what your shame is saying. Write it out and let it go. Meaning, like I said to you, there’s really no point in me dwelling on this because it’s done and I can’t do anything about it. All I can do is be kind to the feelings I’m feeling.

Now, a lot of people will say, “Oh my gosh, I wrote this response on an email or call or I presented, or I was in a party, and now I feel nothing but anxiety because I totally made a mistake.” I’ve had people even say like, “Oh, I was at a party and I passed gas,” or “I said something stupid.” I mean, I could tell you some absolutely ridiculous stories. 

Actually, let me tell you a quick, funny story, because I’ll come back to this, is recently, I attended this creative writing course, but it was actually a writing course for people who are business owners, and they were talking about getting really clear about you and the message you want to give and how to tell stories about it and so forth. And he was asking these questions about, who are you? And what’s something that the people closest to you would say? And I was thinking about it and I don’t think you guys know this about me, but I have, not in my professional life, but in my personal life, I have a way of the most bizarre things happening to me, like silly things. I always find myself in these situations where everyone is like, “Oh, only Kimberley would get put in that situation.” So ridiculous. I can’t even-- one day I think if I really let go, I’ll tell you some ridiculous stories. But if something really bizarre is going to happen, it always happens to me. And so, I just wanted to tell you that, because I want you guys to know that as the podcast is where I get a little more personal and bizarre things totally happen to me all the time. But let me go back. 

So, let’s say you have anxiety. You’re having anxiety about something that happened, and you’re thinking like, “Oh my God.” And your brain is just telling you catastrophe after catastrophe, after catastrophe, all of the worst-case scenarios. The truth is, that’s your brain’s job. Its job is to tell you of all the catastrophes, but it doesn’t mean you need to respond as if they’re all true and happening. And so, again, we go back to these core questions, is how can I stay with the facts that it happened? How can I acknowledge that it is what it is and that I can’t solve it, I can’t make it go away? And how can I act in a way that doesn’t overcorrect again, not over-apologizing, not asking for reassurance, not avoiding those people, not saying too many jokes, and so forth? So, we want to catch that. We want to catch how we go into anxiety and respond in that compulsive way. 

As I said to you at the beginning of this episode, I think that I was for many years doing this very nuanced compulsion of over-checking schedules and even being super neutral and kind to people so that I would never offend them. Stripping my personality down just so I would never harm them or never hurt them, which is not me being authentic, and I can see that now. 

So, these are the things I want you to think about. And then once you identify these strong emotions – again, we’ve looked at guilt, we’ve looked at shame, we’re now looking at anxiety – the job is to ride them out, let the anxiety burn out on its own. We don’t need to tend to it. It happened because we’re human and we’re going to allow it to rise and fall on our own. 

So, here is where I want you now to, number one, give yourself permission to be a human. Humans screw up. It’s a fact. It’s something we have to accept. How can we be in these situations and change the way we react so that we are not beating ourselves up and we’re not overcorrecting for the future? 

The only last thing I’ll say here is, if you’re trying to control what people think about you, you’re never going to win because what they think is a reflection of them. So, here is the last point. I screwed up. It’s just a fact. I put other people out. My mistake is probably going to interrupt some people’s time next week. I don’t like that. That doesn’t line up with my values, but it is what it is. There’s not a lot I can do. But what they think about me is completely a reflection of them. 

So, if let’s say this one person goes, “Oh my gosh, she is such an unorganized person and is horrible,” that really shows the degree in which they’re judgmental. Meaning they haven’t allowed me to show them that I’m more complex than that, that I have many other qualities, and so forth. If they were to say, “Oh my God, you’re fired, you’re terrible,” again, that’s not a fact either. And that’s a reflection of them and their struggle to be flexible and find solutions and so forth. Not that they’re bad, it’s just it’s more of a reflection on them because, in this situation, the people were very kind and they said, “We’ll work it out. We’ll see if we can reschedule you to be later on in the day,” and that it really was a reflection of how flexible they are. 

So, I want you to really remember here that you making a mistake doesn’t make you good or bad. Their judgments about you doesn’t define whether you’re good or bad or that they’re good or bad. It’s just we’re doing the best we can and it’s just it is what it is. 

So, that’s it, guys. We make mistakes. It’s terrible. I know it’s hard. It’s really painful, but can we hold space for the pain and the emotions associated and ride them out without beating ourselves up? That’s the real question. 

Have a wonderful day, everybody.

Jul 8, 2022

SUMMARY:

In this episode, we explore how to manage uncomfortable sensations. Many people do not struggle with intrusive thoughts and intrusive images, but instead, struggle to manage intrusive sensations. My hope is that this will give you some tools to manage these uncomfortable sensations and help you reduce how many compulsions you do to reduce or remove these feelings.

In This Episode:

  • What is an intrusive sensation?
  • What is the difference between an uncomfortable sensation and an intrusive sensation.
  • How to manage uncomfortable sensations such as rapid heartbeat, tingling limbs, numbness, lightheadedness, chest pain, etc.

Links To Things I Talk About:
ERP School: https://www.cbtschool.com/erp-school-lp

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com. CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors. Go to cbtschool.com to learn more.

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EPISODE TRANSCRIPTION

This is Your Anxiety Toolkit - Episode 292. 

Welcome back, everybody. Today, we are talking about something that I very rarely talk about that I should be talking about more because it’s like 20% of the conversations I have with clients. And I’ll explain to you why in just a second. 

First, I’m going to do the review of the week. This one is from Linelulu. And they said:

“Grateful. I am so grateful that I stumbled onto your podcasts. Your soothing voice enhances your messages as I am trying to understand more about anxiety, and panic attacks to be a better support for someone very close to me. Thank you!”

You are so welcome, Linelulu. Thank you for that beautiful review. Please, I know I ask you every single episode. If you benefit from this podcast, this is one way that you can help me. So, if for any reason you feel like you have a few spare minutes, please do go and leave a review. 

The last thing before we get talking about sensations is to do the “I did a hard thing” of the week, and this one is from Camille. Camille says:

“I’ve been managing my dermatillomania,” which we also know is compulsive skin picking, “very well. However, I had a very stressful day and picked my skin pretty bad, in my opinion. I had a party to go to that night with a bunch of people. I didn’t know. And I almost didn’t go. But I pushed myself to go and no one said one thing about my skin. I’m so glad I went and got over the fact that my skin needs to be perfect in that instance.”

Camille, this is so good on so many levels, that you showed up and you did the thing that you wanted to do. And ugh, it’s so good. And how wonderful that you had supportive friends. Again, we sometimes were really hard on ourselves and we think people notice everything about us, every flow, but how wonderful that they embraced you and no one said anything. So, thank you so much for Camille for putting in that “I did a hard thing.” I just love hearing you guys doing all the hard things.

Ep 292 Uncomfortable Sensations Your anxiety toolkit

Now, why do we do this segment? Let’s just go back and look at that. So, most of you know that the thing I say all the time is “It’s a beautiful day to do hard things.” Our brains naturally default to this idea of like, “No, I shouldn’t do the hard thing. I should do the easy thing.” Marketing keeps telling us don’t do the hard thing, do the easy thing. Commercial advertising is always sharing the easy five-step way to do something. And we want to flip the script because while it’s good to have things be easy, when it comes to anxiety and these kind of conditions that we’re often talking about, it’s often important that you stare that scary, hard thing in the face. 

Now, that is the perfect segue into this week’s episode about sensations. Now, at the beginning of the episode, I said it’s crazy that I haven’t done a lot of these episodes because sensations is 20% of the work. Now, why did I say that? In total, the clients that I see and that my staff see in our private practice, they’re coming to us for one of five reasons usually. They either have an intrusive thought that they don’t know what to do with, they have an intrusive feeling that they don’t know what to do with, they have an intrusive urge that they don’t know what to do with, they have an intrusive image that they don’t know what to do with, or they have an intrusive sensation that they don’t know what to do with. Five things. 

99.9% of our patients and of the people that we help come with one of those five problems. It doesn’t matter what you call it. They’re coming with, “This is the experience that I’m having.” That’s so overwhelming and difficult and hard that then they go on to do behaviors to try and manage it, and we teach them how to manage those five things in a way that doesn’t require them to do the behaviors that cause them trouble. 

So, let me give you a little more information about that. So, when we’re talking about sensations, we’re talking about-- let’s first get a definition. What is a sensation? A sensation is a physical feeling or a perception resulting from something that happens or that comes into contact with the body. So, really what we’re saying is a sensation is an experience you have in your body and it’s very specific. So often when I’ll say to a client, “Okay, how can I help?” they’ll say, “Well, I’m anxious.” And I’ll say, “Okay, tell me about your anxiety.” And they’ll then usually go on to say, “Well, I’m having these thoughts,” or “I’m having these feelings,” or “I’m having these urges. I’m having these images,” or “I’m having these sensations, and I don’t like it. They make me uncomfortable.” And when I have them, I do these again, like I said, behaviors that kept me into a ton of trouble. Meaning they’ve got big consequences. 

So, often a sensation we consider to be an obsession, just like an intrusive thought, is an obsession. It’s as relevant. And it’s important if someone has anxiety for us to go, “Okay.” This is a common question. If you were my client, this is a common question I ask. I’ll say, “Imagine that I’m an alien and I’ve never, ever once in my life experienced anxiety, and I want you to tell me what it feels like because it doesn’t make any sense to me.” And often clients will struggle with this because they’ll be like, “Well, I just have anxiety.” And I’ll say, “No, we need to understand what specifically, how do you specifically know you’re anxious?” “Oh, I have tightening in my chest or I have shortness of breath, or I have a lump in my throat or I have these butterflies in my tummy.” So, immediately, once we get that, we’re like, “Okay, now we know what we’re dealing with. Okay, now we have specific sensations and now we can develop tools around them so that when you have them, you don’t either engage in avoidant compulsions or physical compulsions or mental rumination or reassurance or self-punishment.” So important. 

Now, let’s slow down here a little and look at what that looks like for many of my patients and many of you. So, this is not scientific, what I’m about to tell you. This is really just coming off of my stream of consciousness and my experience as a clinician, is I’ve broken them down into four main sensations that my patients report to me. Again, this is not a clinical list. So, I want to preface. I don’t want to ever mislead you into thinking this is scientific. But often one of the sensations that people will feel are physical experiences of anxiety, like I listed. It could be butterflies in your tummy, tightness in your chest, as I just said, and I’ve listed them off. 

The next one is specific sensations around what we call depersonalization and derealization. I’ve done full episodes on those in the past. So, go back and check them out. But this is the experience of this weird feeling. The sensation is like, everything feels strange. I feel like distorted, like I’m in a daydream. It feels very hazy and strange, or I feel like I’m outside of my body. Now while we have words to describe derealization and depersonalization, they are also at their most basic form of sensation, a basic sensation. So, I put that in its own category. 

The next one is similar to anxiety and derealization and to personalization, but I’ve put them under the category of panic. Now, the reason that it’s so important for us to talk about sensations is, people who have panic disorder are very sensitive to the sensations that they have because panic is such a 10 out of 10 anxiety. So, it’s like can’t breathe, racing thoughts, major overwhelmed, dizzy, sweating. These are all sensations. These are all things that we perceive or we experience in our body. 

And then the last one is physical pain. This is a sensation too. When you physically have pain, a tummy ache, that’s also a sensation. 

Now, let’s talk about why I separated those, because I’ll give you a really perfect example of how this gets messy. Most of you know that I have postural orthostatic tachycardia syndrome, which is symptoms of dizziness, lightheadedness, headaches, stomach troubles. And often if you stand for too long, you faint. Now, what does that sound very similar to? You guys are probably laughing at me already. Anxiety. It looks exactly like anxiety except the fainting piece, dizziness, lightheadedness, stomach aches, headaches. So similar. And so, when we have, and this is where it gets difficult, when we have a chronic illness or if we have health anxiety, when we experience a sensation, sometimes we can’t figure out whether it’s real pain and real threat or if it’s anxiety. 

The thing to remember here is the response needs to be similar. So, for me, when I had dizziness and lightheadedness, yes, of course, I’m not going to push myself to a place where I pass out, but I’m going to first stop and go, “Hmm, let me try to dip into these sensations. Instead of catastrophizing them as this is terrible and bad things are going to happen, I wonder what would happen if I just labeled them as a sensation.” 

The thing here is, when we have sensations, and you’re having them right now, believe it or not. It could be an itch. It could be a muscle that’s sore from a workout you had, it could be a stomach ache because you just ate an amazing dinner and you just had a little more than you wish you had, or you’re having anxiety. We all have them. Where we often get into trouble is when we label them as good or bad. So, that’s the main point here first. Are you labeling your sensations as good or bad? 

When I would have my POTS symptoms, I get dizzy. At the beginning, I go, “This is bad, this is bad. Bad things are happening,” which would then give me anxiety, which would make it worse. And now I’ve got this hot mess. Massive hot mess. Same for people with health anxiety. They have tightness in the chest and they go, “Oh my God, I’m dying. I’m having a stroke,” or “I’m having a heart attack.” And when we label it as bad, we get more anxiety, which makes it worse, and now we’re in a cycle. If you’re having a panic disorder and you’re starting to notice that small little tingle of anxiety coming up, this like whoosh of anxiety that whooshes over you when we have a panic attack, and you label this as, “Oh, this is bad, this is terrible. I got to get it to go away,” you can bet your bottom dollar, it’s actually going to feed you more anxiety. So, question whether you are labeling your sensations as good or bad.

Now I’m guessing some of you are thinking, “Well, Kimberley, of course, I’m going to label it as bad. It is bad. It’s terrible. I don’t like it.” And I get you. But we’re here to learn. We’re here to grow. We’re here to recover. So, I want you to think beyond that judgment and look at first the judgment doesn’t help you. Whether it’s true or not, it’s not helpful. It makes it worse. So, let’s work at being nonjudgmental about the sensations that we have. 

The response we have to your sensations can determine whether you get stuck in a cycle of having more discomfort. Let me rephrase that in a different way to make an even bigger point. The response you have to your sensations can determine whether you have anxiety about them in the future. Because if you treat the sensations today like they’re dangerous and harmful and they require immediate emergency, you’re training your brain to perceive those sensations as scary and bad and dangerous. And so next time you have them, your brain is going to send out a whole bunch more anxiety. So important. 

I’ve had my share of panic attacks in my life, but when I have them and if I’m like, “Oh, dear God, please don’t,” I know my brain is going, “What, what, what? What’s wrong, Kimberley? Why are you telling me this is terrible? Okay, it is terrible. I’ll keep sending out anxiety.” But when I can respond by going, “Good one, brain. It’s cool. There’s no amount of sensations I can’t tolerate. It’s fine. I’m going to ride it out.” Again, we don’t know how to bypass it with positivity by going, “It’s great. I love it.” We’re not saying that. But we are saying if we can reframe the sensation as tolerable and manageable, you’re less likely to have anxiety about the sensation tomorrow.

Now, I know a lot of you may be asking, “But how do I know when it’s something to just be uncertain and nonjudgmental about or when I should rush to the hospital and so forth?” Number one, you’ll know. But the other piece, I don’t want to discard you on that one because that’s hard to say, especially if you have anxiety, especially OCD and health anxiety. But the other thing is, for me, if I’m having it and I’ll use me as an example, if I’m having dizziness and lightheadedness, which could be anxiety or it could be my POTS, I just keep on the deferring. I keep on deferring like, “Okay, can I just stay with it nonjudgmental for another few minutes?” If I’m getting to feel really horrible, of course, I’m going to sit down and take a rest. I’m not going to push through and be unkind. But I just keep being curious. Could I it do a little longer? Could I have a little more? Could I be nonjudgmental for another few minutes? 

It’s so important because when it comes to anxiety, the way in which we respond to the sensations is as important as how we respond to intrusive thoughts. Particularly like I said, if you’ve got depersonalization, derealization, panic disorder, physical pain, generalized anxiety, health anxiety, so important. If it’s social anxiety, it’s a big one because a lot of people with social anxiety have an aversion to the sensation of being flushed in their cheeks. But if you respond to your cheeks flushed as bad, you’re probably going to get more of it. It’s paradoxical.

Now, here is one other point I want to make before we finish up, which is there is no sensation you can’t ride out. This was a huge one for me because I’ve had anxiety and I’ve had some pretty bad chronic illnesses. If I go into the day telling myself, “I won’t be able to handle it,” I usually have anxiety about the day. Have you noticed that? I know you can’t answer back, but I really want you to consider the question. Do you notice that in your experience? When you tell yourself “I can’t handle things,” does that actually then create more anxiety for you? And sometimes more depression too, if I can be completely honest. 

Last week, we did a whole episode on depression. I think it’s really important to recognize that. Even I should say other sensations are like depression, that’s that sinking, dark, gray sensation that goes with having depression. I should put that there as the fifth type because that’s a sensation that can be scary too. Grief can be an experience that-- there are sensations associated with grief that feel intolerable. But when we tell ourselves we can’t tolerate them, we actually then create more anxiety and depression. So, these are things to think about when it comes to sensations. 

Now, if you were in an office with me or one of my staff, we are most likely to say, at the end of the day, you’re going to have to say, “Bring it on.” Once you identify the sensation, it really comes to, do you avoid it or do you say it’s a beautiful day to do this hard thing, to experience this hard thing? And so, we would say, “Bring it on.”

Now, in ERP School, we talk about this. I probably should do an episode on this. Let me just actually write myself a note to episode on this. If someone really comes to our office with a stronger aversion to certain sensations, we do what we call interoceptive exposures. We talk about this in ERP School. It’s an online course. But an interoceptive exposure is where we purposely expose you to the sensation that you’re avoiding. 

So, examples might be, if you really don’t like dizziness and you’re doing things to avoid dizziness, we would sit you in our chair and we would spin you around 30 times and then we’d walk the hallway ways with you while you’re dizzy. 

If you’re afraid of shortness of breath, we would give you a very small straw. One of those straws that you use to stir your coffee with, and we would have you practice breathing through that so that you, on purpose, tolerate the feeling of having shortness of breath. 

If you really don’t like the feeling of shortness of breath, like tightness in your chest, we might wrap a bandage around your chest, so tight that it feels like you can’t breathe, just for a few minutes. We’re not here to torture you. But these are examples of interoceptive exposures that we do because not only are we like “Bring it on,” we’re like, “Let’s have more of it.” Let’s practice doing it so we can practice nonjudgment, we can practice non-aversion. We can practice saying I can handle this and learning that we can handle this is cool. So, so cool. That’s the thing. 

So, depending on where you are and how severe you are in your aversion to sensations, there are multiple ways you can respond. I want you just to use this episode as an opportunity for you to check in, where are you in respect to your experience with sensations? Do you have aversion to them? How willing are you to feel them? Questions are my favorite, you guys. You know this about me. So, ask yourself these questions. So important. 

All right. That is it for sensations. I hope that is helpful. I know I took you on a couple of meandering tangents there, but I hope you stayed with me. I love talking to you about this stuff and I hope that that did give you some clarity on how you may handle it in the future. 

All right. I will see you next week. Have a wonderful, wonderful day, and don’t forget, it’s a beautiful day to do hard things. I’ll talk to you later.

Jul 1, 2022

SUMMARY

A few months ago, I posted on social media and asked “What are your best tips for depression” and the response was incredible.  Hundreds of people weighed in and shared their best tips for managing depression with OCD and other anxiety disorders.  

In This Episode: 

  • Hundreds of people with depression shared what skills they use to manage OCD and depression 
  • What skills can become compulsions 
  • How to manage day-to-day depression when you are feeling hopeless (OCD hopelessness) 

Links To Things I Talk About:

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.

Spread the love! Everyone needs tools for anxiety...

If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

EPISODE TRANSCRIPTION

This is Your Anxiety Toolkit Episode 291.

Welcome back, everybody. So, I want to set the scene here because things are shifting. Things have shifted. So, I am right now sitting in my office, which is in Southern California, in the United States. But as this launches and goes live, I will be in Australia for the summer. I think I’ve talked to you guys about this in previous episodes, but my husband and I made a decision that the children and I will go to Australia to see our family for the entire summer. Oh my goodness, what a huge undertaking, but we’re doing it and I am so excited. So, really, I’ve had to batch 10 episodes ahead of time. 

Now, what I’ve done is I’ve done my best to make these the best episodes I can batch for you, like the things that seem to be coming up the most for my clients, the questions my staff seem to be asking the most, and the things that everyone seem to be really, really liking and appreciating on social media.

And so, in preparation for today, I was thinking about what’s one of the most helpful, most enjoyed, and engaged posts on social media, because I do spend a lot of time over on Instagram. And by far, interestingly by far, my most popular post I have ever made in the whole history of me being on social media is tips on managing depression. What? I’m an OCD and an Anxiety Specialist, but yet my most popular post in the whole time I’ve been there is on managing depression. So, that’s what we’re talking about today. 

Now, in order for me to do 10 posts, 10 podcasts, excuse me, in order, I’ve had to manage my time down to the minute because right now we are leaving in 18-- no, what is it? Not 18 days. It’s like 15 days. So, we’re leaving in 15 days. I have all of this in addition to the work because I usually just do these here and there. I’ve had to manage my time, and what I have relied on the most is managing my time using what we call “calendaring.” I talk a lot about this on my online course. If you go to CBT School, we have a whole course on managing time. 

But the reason I also share that with you is as we talk about skills today, we’re going to be talking about cognitive skills and behavioral skills. And if you have depression, I strongly encourage you to go and sign up for that course. It’s not an expensive course. It’s jam-packed with how to schedule your time so that you can lessen the heavy load that you’re carrying or the time about the lists of things you have to do and get done. So, I do recommend you go check that out. Go to CBTSchool.com and I think it’s /time management. Yes, it is. 

We’re about to get into the show. First of all, let’s do the “I did a hard thing.” This one is from Anonymous and it says:

“I stopped driving and spending time with children because of OCD. But yesterday, I drove my little sister to school. I was scared, but I’m so proud of myself. Thank you, Kimberley.”

This is so good. I can’t tell you how many people when they’re anxious, they stop driving. It’s actually a really common question I get on social media. It actually surprised me at first in that how common it is. It’s one of the first things people stop doing, is driving. So, Anonymous, amazing. You are just all for the correct courage and all for the bravery and I’m celebrating you right now. That is so, so amazing. Great, great job. 

And one more thing, let’s do quickly a review of the week. This is from Robin. Robin says:

“I’m not sure how to condense all of my happiness and thanks, but I’ll try. Was recommended to listen to your podcast by my therapist (who is just superb and I’m grateful she exists) and I instantly fell in love with your genuine desire to help which seeps through the sound waves. I am hooked on the real-life stories that I can connect to my own experience and have gotten my sister hooked as well who struggles with anxiety as I do. Thank you for your tools and support!”

Thank you, Robin, for that amazing review. Please do go over. And if you listen to the podcast, leave a review. It does help me help other people and more than ever, that is my biggest mission. 

Ep 291 Tips for managing depression Your anxiety toolkit

 

Tips to Manage Depression (From Hundreds Who Have Been There) 

All right, let’s do it. So, let me just give you a little bit deeper context here. So, what I did is I did a poll on social media. So, just to give you some context, I have around 75,000 followers on social media. So, I posted: “Please just give me your best tips for managing depression.” Hundreds of people wrote in and the reason-- I don’t give you the numbers because I’m bragging. I want you to know this is not just from me. This is from hundreds of people who weighed in, who’ve been there, who’ve had depression and they shared little nuggets of what has helped them. And I want to-- in fact, we actually had to split this post into two because there was just so many submissions that we couldn’t fit them all in one post. So, here we go. 

The number one tip for managing depression and these aren’t in order, by the way, this is not the one that was most popular. This is just as we went through, these were the ones that seemed to be really coming up for the same a lot of people. The first one is-- this is going to be a fun one for you, is many people reported that having a dog or a cat or a pet helped them to feel like they had a purpose in the world, that they were there to take care of someone, and that that pet gave them an incredible amount of love. 

I loved this one. What was interesting, I’ll give you feedback right away, is there was a little controversy and feedback around this. A lot of people were saying, “Please don’t encourage people to get a pet just because they’re depressed. Taking on a pet is a huge responsibility.” There was a little controversy, a little backlash, I would say, over that point. But I really do agree that those who do have a pet and can commit to taking on a pet have found that that’s really helpful for their mental health. Most people said having a pet is the most mindful they are in the day when they’re petting their pet, feeding their pet, cuddling with their pet, listening to their pet, and so forth. So, that I thought was an amazing, amazing tip or thing you could practice. 

Number two, probably again, one of the most important from a clinical perspective is exercise. Now, yes, I know, it’s hard to exercise when you’re depressed, but we do have a ton of research to show that exercise is in fact as effective as an SSRI. Not to say you shouldn’t be on an SSRI. I actually am on all four meds. But exercise is an additional benefit. And so, I strongly encourage everyone to at least get out. It doesn’t have to be strenuous, but around 25 minutes was what most people who have depression said, that was the ideal amount. If you get to that point, you actually get more benefit, which I thought was really cool. 

The next one is: Practice mindfulness. Now again, so helpful. If you have depression, usually, I’m going to guess, your mind tells you a lot of lies, a lot of horrible lies, a lot of absolute painful lies. And a big part of managing it is using what we call mindful-based cognitive therapy. And so, what we mean by that is, first, we are aware and we just observe thoughts as thoughts. We don’t take thoughts as facts. And then the cognitive therapy side is once we identify that we’ve had a thought, we may actually stop to correct it. So, if your brain says, there’s no point, you’re a waste of space or the future is going to be nothing but terrible or my life is nothing but terrible – when it tells us these lies, we can actually stop and go, “Okay, now, number one, that’s a thought and I’m going to observe that thought nonjudgmentally.” And then you can also go, “Okay, let’s actually check the evidence for that depressive thought. Hmm, do I bring purpose into the world? Is the world going to be terrible?” and look for maybe some holes in this theory and start to be curious about whether that’s in fact correct. It’s so important. Mindfulness. I personally think these two, the exercise and the mindfulness, are key, are major keys to managing depression.

The next one that was suggested by a lot of people was to talk to family and friends, even if they don’t fully understand. And I loved that little caveat to go on. As much as depression makes you want to isolate and shut down, make sure that you are going and you’re just connecting with them. You’re talking with them, you’re sharing what you’re going through, even if they don’t understand, because the truth is they won’t. Even if they’ve been through what you’ve been through, they won’t fully get it. They’re not the ones getting fed the lies of depression like you are. Or if you’re a family member, I want you to understand it’s really not helpful to say to someone with depression, “I totally get what you’re going through,” because the chances are you don’t. But that doesn’t mean that we can’t relate on some level. That doesn’t mean we can’t connect and support each other. So, important. So, so important. 

This one was an interesting one. And I want to-- some of these surprised me, but lots of people reported that attending couples therapy, couples counseling, if you’re in a relationship, was helpful for their depression. Now, I wonder if that is because maybe their relationship was a part of what’s very difficult for them, but I can see the benefit in that. I don’t talk about this very often, but I personally love couples counseling. I have no problem admitting that we’ve been to couples counseling before. It is thebomb.com. It is such a beautiful thing to do with your partner. Is it hard? Yes. Is it bumpy? Yes. But there’s something really cool about knowing that you’re showing up to the same place every week with the same goal, which is to strengthen your relationship. That in and of itself is just really, really cool. And a lot of people responded saying that that was really helpful for their depression, which I thought was really cool. 

Next one, you guys aren’t going to be shocked by this, and I definitely wasn’t, which was to practice self-compassion. You guys, depression is nasty. It tells you nasty. I’m doing everything I can not to swear here, but it’s like BS. It tells you such nasty BS. And one of the best insurance policies against that, or one of the best defenders against that, or I should say offense, the offense against that is to practice compassion for yourself, to practice being kind and respectful and being tender to the suffering that you’re experiencing. Because believe me, I do know, I’ve experienced depression throughout different parts of my life. It’s horrible and it feels-- the only way I can explain it is you can’t understand it when you’re in depression because you’re in depression. But once you’re out of the depression, for me, it felt like someone had pulled this gray veil off my head that I didn’t even know was there until I’d come out of a depression by going to a lot of therapy and so forth. And I was like, “Whoa, I had no idea everything was under a gray veil until the gray veil was lifted.” So, that compassion piece is really important because I didn’t know the depression was there until the depression had lifted, if that makes any sense. And had I known it, I probably would’ve been much, much, much kinder to myself. 

Next point, I love this. It’s very similar to what we talked about before, but it says, no matter how much you don’t want to, get up and move your body. Now, I could have easily put this under the category of exercise. But a lot of the comments weren’t-- this wasn’t talking about exercise. It was saying, stand up and stretch was one of them. Just stand up and swing your body around, move it around, get into the flow, let the blood flow around your body. And they were saying that that is a shift in mentality. It’s a shift in mindset. I know even today as I’m recording all these episodes, I’m going to need to practice this, because if I just stay here and I stare into this microphone and I’m looking at the screen, my brain is going to get a little distorted and strange. I’m going to have to go upstairs, shake it off, get a cup of tea, move around. And so, I love that they distinguish this separate from exercise.

Next point, oh my gosh, this is gold right here. It says, do something you used to enjoy. Now, when we’re depressed, often nothing feels enjoyable. Even food isn’t enjoyable anymore, or company might not be enjoyable. The things you used to love, the vibe is gone. But what a lot of people were saying, and this is again from people who’ve had depression and managed it, is they were saying, whether or not you enjoy it now, continue to do the things you used to enjoy, but also spread out. 

This is one thing I didn’t mention here, is a lot of people said, be curious about little things that you used to enjoy that you never really developed as a hobby. So, an example would be, I think somebody said something to the likes of like, I used to love hopscotch. Of course, they loved it when they were very, very little. So, as they got older, of course, they stopped playing hopscotch into their adulthood. But they were like, “I literally wrote down a list of everything I used to enjoy and I just did it, whether I’ve done it for 40 years or not.” So, little things. It doesn’t have to be grand things. It doesn’t have to be hobbies. It could be going, “I remember as a kid, I used to love boba or whatever.” Go and get some. Do the things you used to enjoy, even if they’re teeny tiny. 

Another huge group of people said sunlight. Sunlight is a huge part of managing depression. Now, thank goodness for these, my community, because if I was putting together a podcast or managing depression, I would’ve completely forgotten about the people who have seasonal affective depression because I live in California and I wouldn’t have thought of that. But so many of my followers are from all around the world and hundreds of people responded saying, you have to get sunlight. You have to get exposure, UV lights. There are all these really cool exposure lights that you can talk to your doctor about getting. So, thank you to everyone who wrote this in because I would’ve forgotten that. 

And for me too, what I will say is I work indoors a lot. I work at my desk a lot. Most of you know I am running two separate businesses at once. My private practice and CBT School. So, the days where I don’t just-- even if it’s go outside and sit in the sun while I have a cup of tea for 10 minutes, I do notice a shift in my mood. Again, don’t do too much. We don’t want you to get sunburn. We don’t want you to have too many exposures to UV rays. But I do believe there’s such a benefit for mental health. 

Okay, next one. This one is amazing. So, many people wrote some variation of this, but we pulled it into this one point, which is write a list of “I can” statements. Meaning, when you’re depressed, depression will tell you can’t. “You can’t do that. You can’t do this. What’s the point of doing that? You can’t. Don’t do it. You won’t do it. Don’t do it.” And so, a lot of people were talking about writing a list of either your strengths or your characteristics or things that you can do. And I think that that is such an amazing shift – to write a list of I can’s. I can work out. I can call my friend. I can get some sun today. I can go to therapy. I can play with my dog. It’s very similar to the term “should.” That simple move of saying “I should exercise” to “I could exercise” like “I should be kinder to myself,” or you could say, “I could be kinder to myself,” those small shifts in sentences can make such a difference. So, I like either of those.

Next one, appreciate the little things you do for yourself. You might start to see a trend here. When you’re depressed, the big stuff feels really hard. So, you got to zoom in on the little stuff. And they were saying, appreciate the little things you do for yourself. So, an example might be, “It’s really nice that you made yourself a cup of tea before you recorded these podcasts, Kimberley,” or “Wow, it was kind of you that you bathed today. Great job. Making sure you ate breakfast. Great job. Getting out of bed today.” Often with depression, we go, “Oh, that’s stupid. Why would I celebrate getting out of bed? Everyone gets out of bed. I’m such a loser because I can’t get out of bed.” I mean, that’s the mindset of someone with depression. And so, we want to shift that away from such critical voices and going, “Good job you got out of bed. That’s a big deal when you’re depressed. Good job on brushing your teeth when you’re depressed. That’s a big deal. Good job on saying no to that thing you didn’t want to do. That’s a big deal.” Really, really important. 

I have three left. The third last one is, take your medication. Hundreds of people wrote this in and I just loved it. It filled me with joy because whether you choose to take medication or not is entirely your decision. But 10 years ago, I remember when I was-- 15 years ago when I was starting to do my internship, there was this article. I think it was like a USA Today article or something, and it was talking like, let’s take the stigma out of medication. And so, great. We’re starting to have those conversations. But to see now how the response was of like, “Just take your medication,” it just really made me feel joyful that maybe that means there’s a little less stigma about it, and I really hope that I help you to take the stigma out. 

There’s absolutely nothing wrong with taking medication. In fact, I’ll tell you a quick story about myself, when I-- you’ll probably remember I went through a period in 2019 and 2020 where I was very, very sick and I had severe depression alongside it. And I remember the doctor saying, “Okay, we’ll prescribe you such and such for this condition and such and such. And we’ll prescribe you an SSRI for your depression.” And he didn’t really even ask if I was depressed, he just prescribed it. And I was like, “What? You didn’t even ask me if I was depressed.” And he goes, “No, no. Most people who have POTS,” I have pots, “they get depressed.” And I was like, “Huh, that’s interesting.” And I thought to myself, okay, I don’t-- for a second, I thought, no, I don’t really need it. But then I was like, “You know what? What a gift to give myself the help. If it’s going to help, I’m going to do it. What a gift.” Not that I’m at all encouraging you to take medication, but I just want to share with you my experience. I could have seen it as like, “Oh, I’m so bad. That’s weak and that’s lazy and I should try without it.” But I was like, “You know what? I’m really not well. I’m going to take all the help. And if one form of the help is to take a pill, I’m going to take a pill.” I’m not going to tell myself a story that that’s lazy. In fact, I’m going to say that’s pretty badass, that I would accept the help. I’ll get going. Sorry, I had to tell you that really important story from my perspective. 

All right. Two to go. Second last one: Surround yourself with people who help keep sight of what’s important. This is important. If you’re depressed and you’re surrounded by people, whether it’s physically or on social media, people who are very materialistic or they are striving towards things that actually make your depression worse, find different people. You want to find yourself around people who strive for similar things that are aligned with your recovery. 

I’ll tell you again a different story. As a business person, I love business. I really do. I love being a therapist, but if I wasn’t a therapist, I’d go to business school because I just love it. But I notice that if I’m hanging around with other people who are business-minded, it can get really icky and the messages can get really gross. And I can find myself falling into this trap of winning and wanting more. I was finding that I was starting to be hard on myself until I caught this and was like, “Whoa, I need to unfollow these people because this is not good for my mental health. I need to surround myself with people who have the same goals, like what’s important as their goal.” And that was really, really monumental for me. So, do an inventory of your friends, your family, your social media, your colleagues, and try to only surround yourself with people who support your recovery. 

Last one is, when you’re having this feeling, don’t numb it out. I’m leaving this at the end. I probably should have put it at the front, but don’t numb it out. It’s okay. Sometimes you will need to turn your brain off and watch some TV. But if that’s all you’re doing to manage your depression, the chances are you’re going to get more depressed. That’s why I keep talking about scheduling and calendaring. Because often when we’re depressed, we want to just stay in bed and numb the feeling out. Sleep all day, watch TV just to numb the depression. But that only makes it worse. And this is the behavioral piece of managing depression, which is one of the gold standard treatments for depression is what we call time blocking or activity scheduling so that you schedule your day. Nothing heavy, nothing crazy. But you do that so that in doing that, you actually reduce your depression because you feel accomplished and you don’t feel like the day was a complete waste. Again, there’s a balance. You don’t want to overschedule, but you do want to engage in the day. You want to make sure that you’ve got things planned. So, don’t numb. Try to activity schedule. 

If you need help with that, head over to CBTSchool/-- sorry, you’ll go to products and then there’ll be time management there, or CBTSchool/timemanagement. You can learn that in that course. It’s a really pretty cheap course and it’s pretty quick. It’s like a two-hour course and I walk you through exactly how I do it. 

All right. So, that’s it. There are tips for managing depression. There’s like 12, maybe 15 of them. They’re from hundreds of people who have been there. I just love this community so much. If you haven’t followed me on social media, head over to Instagram under Your anxiety Toolkit, and I’ll be there. Thank you. 

All right. Have a wonderful day. I will see you next week. Next week, we’re talking about sensations and anxiety and panic. So, I’ll see you there. Have a good one, everyone.

Jun 24, 2022

In This Episode, we discuss:

Is it important that you stop doing all your compulsions?
How can I practice Self-Compassion as you move through recovery?
How can you balance facing fears and also being gentle on yourself?

Links To Things I Talk About:

ERP School: https://www.cbtschool.com/erp-school-lp

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.

Spread the love! Everyone needs tools for anxiety...

If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

EPISODE TRANSCRIPTION 

This is Your Anxiety Toolkit - Episode 290. 

Welcome back, everybody. 290, that sounds like a lot of podcast episodes. It’s funny. Sometimes I don’t think of it. If you have asked me on the street, I’d say, “Yeah, I’d have about maybe 110 in the can.” But 290, that is a lot of episodes. I do encourage you to go back and listen to them, especially the earlier ones. They’re my favorite. But no, go back, play around, check out the ones that you love. There’s probably some things there that you could probably go back and have a good giggle at.

All right. We today are talking about a question that came from a student in one of my courses. I’ve found this question to be so important. I wanted to bring it in and have it be a podcast episode because I think this is a very important question and I think it’s something we can all ponder for ourselves.

Now, before we go into it, I would like to give you the “I did a hard thing.” This is a segment where someone shares a hard thing that they’ve done. And I love the “I did a hard thing” segment probably as much as anything.

This one is from anonymous and they said:

“I have contamination OCD. And one thing I’ve avoided for a very long time is raw meat and eggs. Over the winter, I discovered that ERP is so much EASIER (and I use this term very loosely in capital letters) if my exposures are value-based.” This is so good, Anonymous. “So I decided that I wanted to be the mom that baked with her kids, anxiety be darned. I wanted my kids to have warm memories baking in the kitchen with their mom as the snow fell. So each week over the winter, we picked a new recipe, and over the weekend we made it as a family. The first time I cracked an egg, my husband took out his phone and took a picture. He was so proud. The exposure was still hard and I didn’t feel calmer at least while baking, but I tried my best to present and enjoy the time with my kiddos. Later, my son brought home A Joy Is book made at his school. Each page had something on it that brought him joy – fishing with dad, some are vacations. And there on the page.” Oh my God, Anonymous, I’m getting goosebumps. “There on a page was ‘making cookies from scratch with mom.’” Oh my God, I think I’m crying. Oh my goodness. I have goosebumps everywhere. “It is so hard to measure success with ERP sometimes, but that gets real, tangible evidence that I had accomplished something and it felt so good.”

Holy my stars, Anonymous. This is incredible. Wow. This is what it’s all about, you guys. This is what it’s all about. For those of you who are listening, I don’t read these before the episode. I literally read them as just I pull them up and I read them. This one has taken my breath away. I just need a second. Oh my goodness, that is so beautiful. So beautiful. Thank you for sharing that. Oh my gosh, that is so perfect for this week’s episode. All right, here we go.

Do I have to stop all of my compulsions Your anxiety toolkit

 

This week’s episode is about a question, like I said, is it okay to keep doing some of my compulsions? Again, this came from one of the courses that we have. We have two signature courses for OCD. One is ERP School, and then the other one is this Mindfulness School for OCD that teaches mindfulness skills.

Now, the reason I love this question is, they’re asking me as if I am the expert of all things, OCD. And I want to let you in on a little truth here – I am not. You’re probably like, “What is happening? She’s been telling us that she’s an OCD specialist all this time. And now she’s telling me she’s not the expert.” I am not the expert of you. And I want to really make sure that is clear. Anytime someone says, “What should I do? What’s the right thing to do for me?” I try my best not to tell them that is best for them because I’m only telling them what I think is best for them. That doesn’t mean it’s the facts. So, I want to be very clear. I am not the expert in you. You are. You do get to make choices of your own.

That being said-- and I’ll talk more about that here in a second. But that being said, let’s look at the question and just look at it from a perspective of just general concepts of OCD.

Now, in the beginning of ERP School, we have a whole module that explains the cycle of obsessions and compulsions. I draw it out on a big sheet of paper, like this huge sticky note. And it’s actually really funny because I’m trying to squeeze myself into the frame of the video with this huge sticky note. When I think back to it, it makes me giggle. But here let’s take a look.

The thing to remember here regarding this question is, if you have a fear and the fear is what we call egodystonic, meaning it doesn’t line up with your values, you know it’s a fear, and you know it’s probably irrational. If you have this fear and you respond to the fear as if it is dangerous and important and urgent, you actually are keeping your brain afraid of the fear. And you’re continually keeping your brain stuck in a cycle where your brain will set off the metaphorical fire alarm every time it has that fear. When you have fear and it doesn’t line up with your values and you have the insight to see that it’s irrational or that it’s keeping you stuck and it’s not effective for you and not responding anymore, your job is to practice changing your behaviors and your reaction to that thought so that you can train your brain not to set the fire alarm off next time. It may take several times or many times. But again, if you have a fear and you respond to it like it’s important, your brain is going to keep thinking it’s important. If you have a fear or an obsession and you keep responding to it with urgency, your brain is going to keep interpreting that fear as urgent, serious, dangerous, scary things.

So, I’m always going to encourage my patients and my students to always check in on this one golden question, which is, what would the non-anxious me do? Or what would I do if I weren’t afraid of this thought? Or another question is, am I responding from a place of fear, generally? And if that’s the case, then I would encourage my patient to really work at reducing that compulsion because the compulsion keeps the cycle going.

Now, that being said, still, again, I’m going to say, under no circumstances do I get to tell you what to do. Only you will know what’s right for you. And I have had clients, I will say, I’ve had clients where they’ve written out their hierarchy. They’ve gone all the way to the top. And there’s several things at the top where they’re like, “No, I’m actually going to keep these ones. These ones are ones that don’t interfere with my life too much. I’m comfortable. I’m not ready to face them yet. And so, no, I’m going to keep doing them.” And I respect that. Again. I am not the expert on everybody. Everyone gets to make their own value-based decisions. That’s entirely okay.

I always say to them, going to the top of your hierarchy and cutting back on all of the compulsions is, think of it like an insurance policy on your recovery. It’s not going to completely promise you and guarantee that you won’t have obsessions in the future or you won’t have a relapse here or there. No. And that’s okay. That will happen. We’re going to actually have a conversation about that here in the next few weeks on the podcast. But you can help train your brain by marking off all those compulsions.

So, what I’m going to leave you here with-- this is actually not going to be a long podcast, but what I’m going to leave you with is the actual answer to the question. Is it okay if I keep doing some of my compulsions? Yes, it’s okay. You don’t have to be perfect. You don’t have to win all the challenges. And for reasons that are yours, you get to make those decisions. And really that’s your personal decision as well, and-- we don’t say “buy,” we say “and.” And just keep in mind the nature of compulsions. Compulsions keep the cycle going.

Just keep that in mind gently, in a tender place. Put it in your back pocket. And here is the question I’m going to leave you on, is ponder why you don’t want to stop this compulsion. What’s getting in the way? If you’re really honest with yourself, what’s the reason you want to keep doing it? Does doing it keep you aligned with your values? Is there a way to be creative and strategic in this situation where you can slowly reduce the compulsion, even if it’s a baby step? It’s so important just to be pondering and asking yourself questions. I have to always stop and say like, “Okay, Kimberley--” I call myself KQ. Everyone calls me KQ. “KQ, let’s get real. What’s really happening here.?” And I’m not doing it in a mean way. I’m having a heart-to-heart. What’s really happening? What’s really getting in the way? Are you being honest with yourself? And sometimes you have to have really honest conversations to be like, “Oh, I know. I’m totally giving myself stuck here.” And it might take some time before you’re ready, and that’s okay too. Okay?

So, I want you to think about those things. Maybe even write the questions down. Go back and listen, or you can go to the transcript of this podcast. Write those questions down and go back and review them every now and then, because those are questions I ask my patients every single day. Every single day. And the questions I ask myself and the questions I ask my patients are often what defines how successful they are because we’re questioning the status quo. And that’s what gets them better.

Before we finish up, let’s do the review of the week. This is from Robyncox and they said:

“Thank you, Kimberley. I’m not sure how to condense all of my happiness and thanks but I’ll try. I was recommended to listen to your podcast by my therapist (who is just superb and I’m grateful she exists) and I instantly fell in love with your genuine desire to help which seeps through the sound waves.” I love that. “I am hooked on the real-life stories that I can connect to my own experience and have gotten my sister hooked as well who struggles with anxiety as I do. Thank you for your tools and support!”

Thank you, Robin. Again, I love hearing your reviews and I just love hearing that I can be of service and help you and be a part of your day. I love knowing that people are like taking walks, listening to me and we get to have chats together. It’s beautiful. It’s really, really such an honor.

All right. That’s it for Episode 290. That’s a lot of episodes, but I think we’re doing well. I will see you next week for Episode 291 and we will go from there. Oh, one thing to note. By the time you talk to me next time, I will be in Australia. We are going to spend the summer there this year and I could not be more excited. I’ll send you my love from there. Have a great day.

Jun 17, 2022

In This Episode:

  • What is whack-a-mole obsessions? 
  • Why do my obsessions keep changing? 
  • What is the treatment for fears that keep changing? 

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. 

Spread the love! Everyone needs tools for anxiety...

If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

EPISODE TRANSCRIPTION 

This is Your Anxiety Toolkit - Episode 289. 

Welcome back, everybody. I am so happy to be with you again. I won’t lie. I’m still on a high (that rhymed) from the managing mental compulsion series. Oh my gosh, you guys, I am so proud of that series, that six-part series. If you didn’t listen to it, please do go back. I’ll probably tell you that for the next several podcasts, just because I am really still floating on the coattails of how amazingly, so wonderful that was. And it really seemed to help a ton of people, which is so fulfilling. 

I do love-- it’s not because of the ego piece of it, I just do love when I know I’m making an impact. It’s really quite helpful to feel like you’re making an impact. And sometimes when I’m putting out episodes, I really don’t know whether they’re helpful or not. That’s the thing about podcasts compared to social media, is with social media, if you follow me on Instagram @youranxietytoolkit or Facebook, I can get a feel based on how many comments or how many likes or how many shares. But with podcast, it’s hard to know how helpful it is. And the feedback has been amazing. Thank you, everyone who’s left reviews. What a joy, what a joy. 

What the cool thing is, since then, it’s actually created this really wonderful conversation between me and my therapist. So, for those of you who don’t know, in addition to me owning CBT School, I also own a private practice where myself and nine of my therapists were actually, now 10 extra therapists, in the process of hiring a new person. We meet once a week or more to discuss cases. And the cool thing about the mental compulsion series is it brought the coolest questions and conversations and pondering, what would this help this client? How would it help that client? These are the struggles my clients are having. Because as I kept saying, not every tool is for everybody. Some you’ll be like, “Yes, this is exactly what I needed,” and there’ll be other things where they might not resonate with you. And that’s totally fine. It doesn’t mean anything is wrong. That’s because we’re all different. But it’s really brought up a lot of questions. And so, now I’m actually going to hopefully answer some of those questions in the upcoming podcasts. 

Today, we’re actually talking about what to do when your obsessions keep changing. Because we’re talking about mental compulsions and reducing those, and that’s actually the response prevention part of treatment, what’s hard to know, like what exposures do you do for somebody whose obsessions keep changing or their fears keep flip flopping from one to the other? One week, it’s this. Next week, it’s that. And then it’s funny because a lot of clients will say, “What was a 10 out of 10 for me last week is nothing now. And now all I can think about is this other thing. I was really worried about what I said to this one person. Now, all I can think about is this rash on my arm. And the week before that, I was really upset that maybe I had sinned,” or there was another obsession. Again, it’s just what we call Whack-A-Mole. We’re going to talk about that today. 

But before we do that, we are going to do the “I did a hard thing” segment. This one is from Marisa. And Marisa is at the @renewpodcast. I think that might be her Instagram or their Instagram. Marisa said:

“Last week I submitted my dietetic internship applications. It was a long, stressful process and anxiety definitely came up during it. And I was able to move through and do the hard thing. I kept reminding myself that the short-term discomfort of submitting the application was worth the long-term reward of hopefully getting a step closer to my goal of becoming a registered dietician through completing the internship. Even though there is still uncertainty and the outcome that I have to sit with while I wait to find out the results of my application, I have learned through my ERP work that I can sit with the discomfort and uncertainty. Thank you, Kimberley, for reminding me that it is a beautiful day to do hard things.”

Marisa, I hope that you get in. I hope that you get all of the things that you’re applying for. This is so exciting. And yeah, you really walked the walk. This is exactly what we’re talking about when we do the “I did a hard thing” segment. It doesn’t have to be OCD-related or anxiety-related. It could be just hard things because life is hard for everyone. I love this. Thank you so much, Marisa. 

If you want to submit your “I did a hard thing,” you may go to my-- it’s actually my private practice website where I host the podcast. If you go to KimberleyQuinlan-lmft.com and you go to the podcast link, right there, there is a link that says “I did a hard thing.” It’s actually KimberleyQuinlan-lmft.com/i-did-a-hard-thing/ okay? But it’s easier just to go, and I will try to remember to put this in a link in the podcast. 

All right. One more piece of housekeeping before we get going is, let’s do the review of the week. This is from Sass, and Sass said:

“I have had an eating disorder for many years and I spent my adult life trying to understand my compulsions and obsessions. When I found your podcast last summer, everything started to make sense to me. You have given me an understanding and acceptance I couldn’t get anywhere else. I look forward to your weekly podcast and enjoy going back and listening to the earlier podcasts as well. Thank you for all you do.”

Sass, I get you. I was exactly in that position when I had my eating disorder. I didn’t understand it. I didn’t feel like people explained it in a way that made sense to me. And the obsessive and compulsive cycle really made sense to me. So, I am so grateful to have you, and I’m so grateful to be on this journey with you. Really, really, I am. Thank you for leaving that review. 

Whack a mole Obsessions Your anxiety toolkit

 

Okay, let’s do it. Today, we are talking about Whack-A-Mole obsessions. Now, Whack-A-Mole obsessions is not a clinical term. Let’s just get that out of the way. There is nothing in the DSM or there’s no-- it’s not a clinical scientific term, but it is a term we use in the OCD community. But I think it’s true of the anxiety disorder community. Maybe even the eating disorder community as well, where the fears flip flop from one thing to the other. This may be true too if you have health anxiety. It might be true if you have generalized anxiety, social anxiety, where one day everything, it just feels like this fear is so intense and it’s so important and it must be solved today. It’s so painful. And then for no reason, it goes. And then it gets overshadowed by a different fear or obsession or topic. 

And what can happen in treatment is you can start to treat one, doing exposure. This was actually one of the questions that came up through ERP School, which is our online course that teaches you how to create a plan for yourself to manage OCD. Some people will say, “Oh, I created a hierarchy. I followed the steps in ERP School. I started working on it and I did a few exposures and I did a few marginals. And boom, it just went away and then a new one came or the volume got turned down.” It could be that you addressed it a small amount, and then it went away and got replaced by another. Or it could be that you didn’t even get time to address it and it just went to a different topic. And this is really, really distressing for people, I’m not going to lie, because you’re just constantly whack-a-moling. You know the Whack-A-Mole game? You’re whack-a-moling things that feel super important, super scary, super urgent. 

And so, what I want to do first is just validate and recognize this is not an uncommon situation. If this is happening for you, you are definitely not alone. And it doesn’t mean in any respect that you can’t get better. In fact, there’s a really cool tool, and I’m going to teach it to you here in a second, that you can use. We use it with any obsession. This is not special to Whack-A-Mole obsessions, but you can use it with any exceptions or if things keep changing. But first of all, I just want to recognize it is normal and it’s still treatable. 

What do you do? The thing to remember here is, when you zoom out, and this is what we do as clinicians, our job as clinicians, and I say this to my staff all the time, is to find trends in the person’s behaviors and thinking. And what you will find is, when you’re having Whack-A-Mole obsessions, while the content may be different, when you zoom out, the process is exactly the same. You have a thought, a feeling, a sensation, or an urge that is repetitive, that is uncomfortable, that creates a lot of distress in your life. And of course, naturally, you don’t want that distress. That’s scary. And so, what you do is you do a compulsion to make it go away. It doesn’t matter what the content is. It doesn’t matter what the specific theory is. This is the same trend. And so, when we zoom out, we can see the trend, and then we can go, “Aha. Even though the content is the same, I can still intervene at the same point.” When we talk about this in ERP School, is the intervention point is at the compulsion. 

And so, the work here is the content doesn’t matter. Your job is to catch and be aware, like we’ve talked a lot about mindfulness, is to be aware and identify, “Oh, I’m in the trend. I’m in the cycle.” While the one content has changed, the same behaviors are playing out. So, you catch that. You then practice being willing to be uncomfortable and uncertain about the content, because that’s the same too. The same cycle is happening. The thought and the fear create some anxiety, some sensations, and so forth. 

And then we have an aversion to that. And then our job is to work at not engaging in that compulsion. So, that compulsion might be mental rumination. It might be doing certain behaviors, physical behaviors. It might be reassurance seeking. It might be avoidance. It might be self-punishment. It might be self-criticism. And your job is actually to go, “Okay, it really doesn’t matter.” And I really want to keep saying that to you. If the fear is, what if I have cancer? What if I’m going to hurt someone? What if I’m aroused by this? What if I have sinned? What if things are asymmetrical? What if I got some contaminant? What if I don’t love him enough? It doesn’t matter. What if it is not perfect? What if I fail? It doesn’t matter. I’ve just listed some, but if I didn’t list your obsession, please don’t worry. It’s for every one of these. The content for all of them are equally as important. 

Sometimes what we do is we go, “Oh, that one is okay. But this one is really serious, and we have to pay attention to it.” And so, we have to catch that and go, “No, it’s all content. It’s all--” you could say, some people say it’s all spam, like the spam folder. Because when we get an email, we have emails that we really need to see – events, meetings coming up. And then we always have spam, the stuff that’s like, “Please send me money for Bitcoin,” or something. So, we put that in the spam folder. And so, your job is to catch the trends here, the patterns, and learn how to put those obsessions in the spam folder, no matter what the content.

Now, this does require, and here’s the caveat, or I would say this is the deal-breaker, is it does require a degree of mindfulness in your part to be aware of what’s going on. And this is a practice, like a muscle that you grow. So, what it requires is you have to be able to catch that you are in the content. You have to be able to catch that you are in the cycle that keeps you stuck. And that does require you to be mindful again. And I get it. I’m not saying that you’ll ever be perfect at this because I don’t know anyone who is. There will be times when you’re so caught up in the content and you’ve been doing compulsions for an hour, two hours, two days, two months and you haven’t caught it. And you’re like, “Oops, wait. Oops, I didn’t catch that one.” That’s okay. We don’t beat ourselves up. Then we just go, “All right, I’m at the point where at least I’ve caught it. I’m aware that I’m in the content. I’m aware how this is playing out exactly the way that it played out yesterday, but with a different obsession.” And then you just move on from there. Don’t beat yourself up. But it does require you to strengthen the muscle of being able to catch that you’re in the content. And it’s what we call insight. It’s having the insight to recognize.

Now, insight is something we can strengthen with practice. It’s not just one and done. It’s practice. It’s repetition. I have to do this all the time for myself. While I don’t have OCD, I do have anxiety and I will catch myself going down the rabbit hole with something until I’m like, “Wait, wait, wait, wait, wait, you’ve been here before. It looks exactly like what you did on Tuesday where you’re trying to figure out something that’s not in your control. Kimberley, this is not in your control. You’re trying to control something that isn’t even your business.” And I’ve seen that trend in me. And so, my job is to catch it. Once I can catch it, then I know the steps. I know, “Okay, I got to let this one go. I got to accept the discomfort on this one. I’m going to have to ride this wave of discomfort. I’m going to have to radically be kind to myself.” We know the steps. And once we can get those steps down, it’s about catching it. But this is what we do when the obsessions do keep changing. 

Now, I’m not going to say this is easy because it’s not. And if you require help doing this, reach out to an OCD therapist or an anxiety specialist who knows ERP. Remember here, and I’m telling you this with the deepest, most absolute degree of love, is CBT School, the whole mission of CBT School is to provide you tools and resources for those who don’t have tools and resources. So, if you haven’t got a therapist and you’re finding this really, really helpful, but you’re still struggling, don’t be afraid. It doesn’t mean anything is wrong with you. It just means maybe you need some more professional help. Maybe you have a therapist and you’re listening into this just to get extra tools. Great. Take what you learn and then take what struggles you have and figure that out. 

I really want to stress here, and the reason I bring that up is, when I say this, it isn’t as easy as it sounds and it does require sometimes having somebody else, this is why I go to therapy myself, is even though I know the tools, it’s really nice to have a second set of ears just going, “Wait a second. Sounds like you’re caught up in the content.” If it’s not a therapist, maybe you could have a loved one or even journaling I have found is really helpful in that when you journal it down, and I do this regularly, I then read it, not to judge it, but just to see what trends. And I get a highlighter and I just highlight like, where are the trends? Where am I seeing the same patterns playing out? And that’s where we intervene. 

So, that’s Whack-A-Mole obsessions. That is what to do when your obsessions keep changing. I do hope that that was helpful, not just to validate you, but to give you some skills moving forward. I am so grateful to have you here. Don’t be afraid to let me know what you think. I love, again, getting your feedback via reviews. I urge you to join the newsletter. That will then allow you to reply and give me feedback that way. I love hearing from you all. 

All right. I’m going to sign off and I’ll talk to you very, very soon.

Jun 10, 2022

SUMMARY: 

Today, I share what to do when you get “bad” news.  This episode will share a recent situation I got into where I had to use all of my mindfulness and self-compassion tools.  Check it out!

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. 

Spread the love! Everyone needs tools for anxiety...

If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two).

 

EPISODE TRANSCRIPTION 

This is Your Anxiety Toolkit - Episode 288. 

Welcome back, everybody. We literally just finished the six-week series on managing mental compulsions. My heart is full, as full as full can be. I am sitting here looking into my microphone and I just have a big, fat smile on my face. I’m just so excited for what we did together, and I felt like it was so huge. I have so many ideas of how I want to do something similar in the future with different areas. And I will.

Thank you so much for your feedback and your reviews. I hope it was as helpful as it was for me, even as a clinician. I found it to be incredibly helpful, even as a supervisor, supervising my staff. I have nine incredible staff who are therapists, who help treat my clients and we constantly keep referring back during supervision of like, “Do you remember what Lisa said? Do you remember what Reid said? Listen, let’s consider what Jon said or Jon Hershfield said, or Shala Nicely said.” It was just so beautiful. I’m so grateful.

If you haven’t listened, go back and listen to it. It’s a six-week series and ugh, it was just so wonderful. I keep saying it was just so wonderful. So, if you go back, I did an introduction, Episode 282. And then from there, it was these amazing, amazing experts who just dropped amazing truth bomb after amazing truth bomb. So, that’s that.

Today, I am going back to the roots of this podcast. And I’m sharing with you-- for those of you who have been listening for a while, we usually start the episode with a segment called the “I did a hard thing” segment. This is where people write in and tell me a hard thing that they’ve done. If you go to my website, which is KimberleyQuinlan-lmft.com. There on the podcast page is a place to submit your “I did a hard thing.” And today’s “I did a hard thing” is from yours truly. I just had to share this story with you. I feel like it’s an important story to tell you guys, and I wanted to share with you that I’m not just talking the talk over here, I’m walking the walk.

So, today’s episode is called When You Get Bad News. I’m just going to leave it at that. Before we get started, I would love to leave you and share with you the review of the week. This is from hannabanana3131, and they said:

“Fantastic mental health podcast. Such an amazing podcast. I have learned so many useful tools for dealing with my anxiety and OCD. And Kimberley is such a loving, compassionate coach - I feel like she’s rooting for me every step of my healing journey,” and she’s left a heart emoji.

Thank you so much, hannabanana. I love, love, love getting your reviews. It does help me so much. So, if you have a moment of time and the podcasts are helpful for you, that is the most helpful thing you can do back. When we get reviews, then when people who are new come over and see it, it actually makes them feel like they can trust the information we’re giving. And in today’s world, trust is important. There is so much noise and so many people talking about OCD and anxiety, and it’s easy to get caught up in nonsense stuff. And so, I really want to build a trust factor with the listeners that I have. So, thank you so much for doing that.

Okay. It’s funny that hannabanana says, “I feel like she’s rooting for me,” because the “I did hard thing” is me talking about my recent experience of having a root canal. Worse than a root canal. So, let me tell you a story now. I’m not just telling you this story to tell you a story. I’m telling you this story because I want to sometimes-- when we do the “I did a hard thing” segment, it’s usually very, very short and to the point, but I’d actually like to walk you through how I got through getting some really bad news. So, let’s talk about it. And I’ll share. I’m not perfect. So, there were times when I was doing well and there was times when I won’t.

So, for those of you who don’t know, which I’m guessing is all of you, I have very bad gums. My gums, I inherited bad gums. It comes in my family. I go in every three months for a gum routine where they do a deep cleaning or they really check my gums to make sure there’s not receding too much. And because of that, I take really good care of my teeth. And because of that, I usually have very little dental issues. I never had a cavity. I’ve never had any cracks or any terrible swollen problems. That just isn’t my problem. My problem is gums and it’s an ongoing issue that I have to keep handling.

So this time, I go in, I get my x-rays, and the doctor comes in. And I have this really hilarious dentist who has not got the best bedside manner, but I do love him and he has been with me through some really tough times that when I found out I have a lesion on my brain, I fully broke down in front of him and he was so kind and gave me his cell phone number. He was just so lovely. But he comes in and he rubs his hands together and says, “What are we doing here today, Kimberley?” And he looks at the x-rays and I kid you not, he says, “Holy crap!” Literally, that was his response, which is pretty funny, I think.

From there, I proceed to go into some version of a panic attack. I’m like, “What? What’s wrong? What do you see? What happened?” And I think that was pretty appropriate for me to do that. So, I want to validate you. When you get big news, it’s normal to go into a fight or flight, like what’s going on, you’re hypervigilant, you’re looking around.

Now, he waited about 45 seconds to answer my question. I just sat there in a state of panic while he stared at the x-rays on the wall. And these 45 seconds, I think, was the longest 45 seconds of my life because he wouldn’t answer me. And I was just like, “Tell me what’s wrong. What’s wrong?” So, he turns around and he says, “Kimberley, you have a dead tooth.” And I’m like, “What? A dead tooth? What does that even mean?” And he says, “You have a tooth infection that is dormant. Do you have any pain? Do you have a headache? What’s going on?” And I’m like, “Nothing, nothing. I’m fine. Everything is fine.” And so, he proceeds to immediately in this urgent, panicky way, call in his nurses, “Bring me this, bring me that, bring me this, bring me that. Bring me this tool, bring me this chemical or medicine or whatever.” And they’re all poking at me and prodding at me and they’re trying to figure it out. And he’s like, “I cannot figure out what this is and why it’s here.” So, bad news. Just straight-up bad news.

Now, the interesting thing about this is, it’s hard to be in communication with someone, particularly when they’re your doctor and they appear to be confused and panicking. Not that he was panicking, but he was acting in this urgent way. That’s a hard position to be in. And if you’ve ever been in a position like that, I want to first validate you. That’s scary. It is a scary moment that your trusted person is also panicking. Just like when you’re on an airplane and it’s really bumpy. But if you see that the air hostesses are giggling and laughing, you’re like, “Okay, it’s all good.” But when you see their faces looking a little nervous, that’s a scary moment. So, first of all, if you’ve been in that position, that’s really, really hard.

What he then proceeded to tell me is, “Kimberley, this tooth has to come out. It has to come out immediately. We cannot wait. It’s going to cost a god-awful amount of money. And this has to happen right away.” Now in my mind, you guys know me, I am really, really strict about scheduling. I have a schedule. I’m not compulsive about it, but I run two businesses. I have a podcast, I have two children. I have a medical illness. I have to manage my mental illnesses all the time. So, I have to be really intentional with my calendar.

So, this idea that immediately, everything has to change was a little alarming to me. But what I remember thinking, and this is one of the tools I want to offer you for today, is being emotionally flexible is a skill. And what we want to do in those moments, and this is what I practiced was, “Okay, Kimberley, this is one of those moments where your skills come in handy. Thank God for them.” How can you be flexible here? Because my mind wanted to go, “You got to pick up the kids and you’ve got to do this and you’ve got to a meeting tomorrow and you’ve got clients and you can’t do this. This can’t happen this week.” But my mind was like, “I’m going to practice flexibility.”

In addition to that, when things change really quickly, we tend to beat ourselves up like, “Such and such is going to hate me. They’re going to be mad at me. They’re going to think I’m a loser for having to change the schedule.” And I just gently said to myself, “Kimberley, we’re going to be emotionally flexible here and we’re going to let everybody have their emotions about it.” So, the kids get to have their emotions about everything changing and my clients get to have their emotions about it too. And having to cancel the meetings, they get to have their emotions. Everyone’s allowed to have their emotions about the fact that many, many things are going to be canceled in the next few days.

And that has been such a work of art for me, but it has been so beautiful for me to say, instead of me going, “No, no, no, I can’t do this,” because I don’t want them to have feelings and I don’t want them to think this about me, now I’m just like, everyone gets to have their feelings. They get to feel disappointed. They get to feel angry. They get to feel annoyed. They get to feel irritated. They get to feel sad. Everybody gets to feel their feelings about it because that’s a part of being a human. That’s one of the tools I want you to think about. Just play with these ideas. You’ve just come off the six-week series. These are some more ideas to play with.

But then from there, I had about 36 hours where I had to wait for this surgery. And during that time, I had to have an x-ray where I was told, and this is the real bad news, is this infection, actually, this is gross. So, trigger warning, guys. The infection actually ate through a part of my jaw bone. I know. Isn’t that crazy? The infection was so bad and it was right at this area where I guess nerves come out of your jaw. There’s this tiny hole right at the front, around the sides where the nerves come out of your jaw and up into your lips and the infection spread and was all over that area. I know that is gross, but it’s also really scary.

So, not only did I have to think about all of the changes, but he, the doctor, the dentist had made me very aware that this surgery has to go really well, and that if he pushes too hard or he pulls too hard with a tooth or he had to put in a-- there’s these words I don’t even know, but like a canal, like some kind of fixture so that he can create a new tooth because I had to have a tooth completely pulled out. He was like, “If I push it in too far, I actually may hit this nerve, which could be very, very bad.”

So, this uncertainty felt horrible to me. And of course, I’m going to have these intrusive thoughts like, “What if I never get to speak again? What if I lose a feeling in my gums and what if he pushes hard and this is terminal? What if, what if, what if, what if?” And so, my skill here, and we’ve learnt this from managing mental compulsions, is bring it back to the present. Until there’s a problem, we don’t solve them. So, that’s what I kept doing. “It’s not happening now. Kimberley, it’s not happening now. It’s not happening now,” even though it’s a real threat, even though it’s going to be something I have to face, because sometimes our fears are like, “What if something happens?” But it’s just a what-if. There’s no actual event that you know for certain is going to happen.

This was like, “Yeah, you’re going to do this in literally 30 hours and all of these risks are here.” You guys have probably got stories like this, where you’ve gone in for some brain surgery or any surgery where there’s a risk, but this risk was pretty huge. He was very concerned. I think appropriately concerned.

So, here I am for 30 hours, managing this stuff where I’m like, “Okay, this could go really well or this could go really bad, like really, really bad.” I giggle just because it makes me nervous just to think about it. That’s a nervous giggle that you just heard me. I don’t know. I often giggle when I’m nervous. But it’s a big deal. So, I, in these moments, had to weigh up, go back to what Lisa Coyne was talking about. I was like, “Okay, values versus fear. Which one do I consult with?” I had reached out to the dentist to say, “You know what, let’s just not do this. I’m not in any pain. Let’s just keep it there. Let’s just not.” And his response was like, “That’s not even an option. If you’ve already got this much damage, this could get worse and be very, very problematic.” So, I didn’t even have the option to back out. I had to do this.

And so, as I proceeded forward, I had to keep being aware like what Jon Hershfield talked about and Dr. Grayson and Dr. Reid Wilson, and Shala. I had to really allow all the intrusive thoughts to come like, “Yup. Possible. Yup, that’s possible too. Yup, that’s possible too. Maybe it does. Maybe it will. Not going to give it my attention right now. I see you’re back again. Good one, bro. Hi there, I see you. I fully accept the uncertainty.” That was me for l30 hours, literally bringing in every tool I have.

The cool thing is it was a hugely busy week. And because I have been really doubling down on my mindfulness skills over the last few months, that actually really helped. Every time I noticed that I was getting anxious, I was like, “Okay, what does the keyboard feel under my fingers?” I have these fiddles that I play with and I’m like, “Okay, what does this feel like? This rubber feel like, or this metal feel like, and so forth?” So, that was really helpful.

The day of the surgery, I go in and I’m fully anxious. I’m going to the bathroom. I’m needing to pee. I feel dizzy. I’m not allowed to be on my medication. Oh, and that’s the other thing, is this maybe the-- what do you call it? The silver lining. Just a little update for you guys, is there is a small chance, because this infection has been here for a long time and we haven’t actually detected it yet, that it may be the reason for all my POTS symptoms. As some of you may know, I have postural orthostatic tachycardia syndrome. It is a chronic illness related to dysautonomia. It causes me to faint and have headaches and nausea and dizziness and blood pooling and it’s the worst. And there is a chance that that might be why. So, I’m half scared and half excited all day, which is a lot to handle.

But as the day is moving forward, I’m getting more and more nervous and I start to feel the urge to start to seek reassurance. I start to observe the urge to Google. I start to observe the urge to ask the doctors many, many, many, many questions. And when I say it, I’m saying that very intentionally. I observed the urge, which is I didn’t do those behaviors. I just noticed the urge that kept showing up. “Ooh, let’s try and get this anxiety to go away. Ooh, let’s try and get that anxiety to go away.” Knowing that when it’s my turn to sit in that chair, I will ask specific questions. So, I’m not saying you can’t ask your doctors questions, but that was key for me, was to observe the urge to seek reassurance, observe the urge to go into avoidance.

I’m not going to make this story too much longer, but what I will say, I want to tell you the funniest part of this story. I’m in the doctor’s office because I had to go in for this very fancy x-ray that does all your nerves because he was afraid he was going to hit one. He’s showing me the x-ray and I’m literally looking at it. He’s showing me cross-sections of my jaw. And you guys, it was so scary. You can see the hole that it’s created. You can see the infection and how it’s deteriorated the bone. It was so scary. And so, he puts his hand on my-- and I’m like, at that point, “Is there any way we could get away with not doing this? Because this is really scary.” He puts his hand on my hand, he says, “I’m going to go and take care of all of these last patients I have so I can give you 100% of my attention and I will be back.”

You guys, this is the funniest thing ever. So, the dental nurse is there watching me. My heart is through the roof. My blood pressure is all over the place. She stands in front of me and she says, “Miss Kimberley, don’t be worried. We’ve watched all the YouTube videos.” And I swear to you, every piece of panic that I had went out the window for that small second and I laughed so hard. She said, “In fact, that’s where the doctor is right now. He’s just going to watch the YouTube video one more time.” And I just died laughing.

Now for some of you, that may have actually been really anxiety-provoking. But for me, it was exactly what I needed. I needed someone to make this so funny. And it was so funny. I swear to you, every time I think of it, the way she says it in her accent was the most hilarious thing ever. It was so perfectly timed. The delivery was perfect and I burst out laughing.

He comes back in-- this is the end of the story. I’m not going to drag it out for too much longer. I promise. But he comes back in, and I just wanted to share with you, because I know last week with Lisa, I had a really emotional moment, and I think it was really tied to this. As he was putting in the IV – because I had to be knocked out. He said he couldn’t take a risk of me moving. So, he knocked me out for the surgery – tears just rolled out of my eyes. And I wasn’t going to be ashamed of it. And what came up for me was, I said, “Please, sir.” I said “Sir,” which I think is so funny, because I know him by his first name. “Please, sir. Please just take care of me.”

And for me, tears were rolling down my face, but that was an act of compassion for myself. Instead of me saying-- because I know two years ago, or even six months ago, I probably would’ve said, “Please, don’t kill me,” or “Promise me nothing bad would happen.” But there was this act of compassion that just flowed out of me, which was like, “Please, sir. Please take care of me.” And it was coming from this deep place of finally in my life, being able to ask to be taken care of. And I’ve been working on this, you guys, for about a year, is having the ability to actually ask for help has been something I’ve really sucked at and it’s something I’ve worked so hard at. And for me, that was groundbreaking, to ask for help.

Now you could say it was me pleading with him, but it wasn’t. It was me. It was an act of compassion. It was an act of saying, “I’m scared. I’m not asking you to take my fear away. I’m just asking you to hold me in a place of kindness and compassion and nurturing and care.” And that for me was profound.

So, I just wanted to share that with you. I know that it might not be as skills-based as some of the other episodes, but I love sharing with you hard things and I love sharing with you that I’m a human, messy human who’s doing the best they can and is imperfect too. But I just wanted to give you a step-by-step one. It’s okay if it’s hard and there are skills that you can use and we can get through hard things. It’s a beautiful day to do hard things, I always say that. And so, I wanted to just record this and share with you the ups and the downs of my week and help you maybe if there’s a time where you’ve gotten bad news on ways that you might manage it.

Now, what I do want to end here with is, I understand my privilege here. I understand my privilege of getting bad news and being able to get medical care and have a lovely dentist and a lovely nurse who makes funny jokes. And sometimes the news doesn’t end well, and I get that. I want to honor you that there is no right way to get bad news. And the grief process of getting bad news is different for everybody. This was more of an anxiety process, but I want to honor to you that if you’re going through some hard thing in your life where you’ve gotten bad news, I want to also offer you the opportunity to grieve that and I want to honor that this is really, really a hard thing to go through. So, I really want to make sure I make space for you with that because my experience is not your experience, I’m sure.

So, that’s it, guys. That’s what to do when you get bad news. That’s my experience of getting bad news and I hope it’s been helpful.

We are embarking on some shifts here with the podcast. I am so inspired to be more focused on just delivering the tools to you and being a safe place for you and being a bright, shiny light for you. And so, I’m doing a lot of exploring on how I can do that. So, if you ever-- again, please do feel-- if you want to give some thoughts, please do reach out, send me an email. If you’re not on my newsletter list, please do go and sign up. I’ll leave you a link in the show notes, or you can go to CBTSchool.com and sign up for the newsletter and you can reply there as well or you can leave a review.

All right. I love you guys. Have a wonderful day. It is a beautiful day to get bad news and do the hard thing. I love you. Have a great day.

Jun 3, 2022

SUMMARY: 

In this episode, we talk with Lisa Coyne about ACT For mental compulsions.  Lisa Coyne addressed how to use Acceptance and Commitment therapy for overcoming mental compulsions. We cover how to identify your values using a fun little trick!

In This Episode:

  • How to use Acceptance & Commitment Therapy to manage mental compulsions
  • How to practice Willingness in regards to reducing mental rituals and mental rumination 
  • A fun little Value Based tool for identifying your values. 
  • How to be curious instead of thinking in a limited way. 

Links To Things I Talk About:

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.

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Managing Mental Compulsions (With Lisa Coyne, PhD) Your anxiety toolkit

 

EPISODE TRANSCRIPTION

This is Your Anxiety Toolkit - Episode 287. 

Welcome back, everybody. I am so excited. We are at Episode 6 of this six-part series of how to manage mental compulsions. You guys, we could not end this series with anyone better than Dr. Lisa Coyne. I don’t know if you’ve heard of Lisa Coyne. I bet you, you probably have. She is the most wonderful human being. 

I have met Lisa, Dr. Lisa Coyne multiple times online, never in person, and just loved her. And this was my first time of actually getting to spend some really precious time with her. And, oh my gosh, my heart exploded like a million times. And you will hear in this episode, you will hear my heart exploding at some point, I’m sure.

I am so honored to finish out the six-part series with Lisa. This series, let me just share with you how joyful it has felt to be able to deliver this as a series, as a back-to-back piece of hope. I’m hoping it has been a piece of hope for you in managing something really, really difficult, which is managing mental compulsions.

Now, as we finish this series up, I may or may not want to do a recap. I’m not sure yet. I’m going to just see where my heart falls, but I want to just really first, as we move into this final part of the series, to remind you, take what you need. You’ve been given literally back-to-back some of the best advice I have ever heard in regards to managing mental compulsions. We’ve got world-renowned experts on this series. You might have either found it so, so educational and so, so helpful while also feeling sometimes a little bit like, “Oh my goodness, there’s so many tools, which one do I use?” 

And I really want to emphasize to you, as we finish this out, again, so beautiful. What a beautiful ending. I almost feel like crying. As we finish it out, I really want to remind you, take what you need, take what’s helpful, or – well, I should say and – try all of them out. Practice with each of the skills and the concepts and the tools. See what happens when you do. Use them as little experiments. Just keep plugging away with these skills and tools. Because number one, they’re all evidence-based. I very carefully picked the experts on this series to make sure that we are bringing you evidence-based, really gold standard treatment. So, that’s been a priority. Just practice with them. Don’t be hard on yourself as you practice them. Remind yourself, this is a long-term journey. These are skills I still practice. I’m sure everyone who’s come on the show, they are still practicing them. And so, I really want to send you off with a sense of hope that you get to play around with these. Be playful with them. Some of them will be we’ve giggled and we’ve laughed and we’ve cried. So, I want you to just be gentle as you proceed and you practice and remind yourself this is a process and a journey. 

That being said, I am going to take you right into this next part of the six-part series with Dr. Lisa Coyne. This is where we bring it home and boy, does she bring it home. I feel like she beautifully ties it all up in a ribbon. And I hope it has been so helpful for you. Really, I do. I want this to be a resource that you share with other people who are struggling. I want to be a resource that you return to when you’re struggling. I want it to be a place where you feel understood and validated. And so, thank you so much for being a part of this amazing series. That being said, let’s get over onto the show, and here is Dr. Lisa Coyne.

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Kimberley: I literally feel like I’m almost in tears because I know this is going to be the last of the series and I’m so excited. I had just said this is going to bring it home. I’m so excited to have Dr. Lisa Coyne. Welcome.

Lisa: Thank you. It’s so nice to be here with you, Kim. Hi, everyone.

What is a Mental Compulsion? Do you call it a Mental Compulsion or a Mental Ritual? 

Kimberley: Yes. So, first of all, the question I’ve asked everybody, and I really am loving the response is, this is a series on managing mental compulsions, but do you call them mental compulsions, mental rituals, rumination? How do you conceptualize this whole concept?

Lisa: I would say, it depends on the person and it depends on what they’re doing. I call them any number of things. But I think the most important thing, at least for me in how I think about this, is that we come at it from a very behavioral perspective, where we really understand that-- and this is true for probably all humans, but especially so for OCD. I have a little bit of it myself, where I get caught up in the ruminations. But there’s a triggering thought. You might call it a trigger like a recurrent intrusive thought that pops up or antecedent is another word that we think of when we think of behavior analysis. But after that thought comes up, what happens is the person engages in an on-purpose thing, whatever it is that they do in their mind. It could be replacing it with a good thought. It could be an argument with yourself. It could be, “I just need to go over it one more time.” It could be, “I’m going to worry about this so I can solve it in advance.” And that part is the part that we think of as the compulsion. So, it’s a thing we’re doing on purpose in our minds to somehow give us some relief or safety from that initial thought. 

Now the tricky part is this. It doesn’t always feel like it’s something we’re doing on purpose. It might feel so second nature that it too feels automatic. So, part of, I think, the work is really noticing, what does it feel like when you’re engaging in this activity? So, for me, if I’m worrying about something, and worry is an example of this kind of doing in your mind, it comes with a sense of urgency or tightness or “I just have to figure it out,” or “What if I--” and it’s all about reducing uncertainty really. 

So, the trick that I do when I notice it in me is I’ll be like, “Okay, I’m noticing that urgency, that tension, that distress. What am I up to in my head? Am I solving something? Is that--” and then I’ll step back and notice what I’m up to. So, that’s one of my little tricks that I teach my clients.

Kimberley: I love this. Would you say your predominant modality is acceptance and commitment therapy? What would you say predominantly you-- I mean, I know you’re skilled in so many things, but what would you--

Lisa: I would say, it’s funny because, yeah, I guess you would. I mean, I’m pretty skilled in that.  I’m an ACT trainer. Although I did start with CBT and I would say that for OCD, I really stick to ERP. I think of it as the heart of the intervention, but we do it within the context of ACT.

ACT for Mental Compulsions 

Kimberley: Can you tell me what that would look like? I’m just so interested to understand it from that conceptualization. So, you’re talking about this idea. We’ve talked a lot about like, it’s how you respond to your thoughts and how you respond and so forth. And then, of course, you respond with ERP. What does ACT look like in that experience? I’d love to hear right from your mouth.

Lisa: Okay. All right. So, I’m going to do my best here to just say it and then we’ll see if it sounds more like ACT or it sounds more like ERP. And then you’ll see what I mean when I say I do both of them. So, when you think about OCD, when you think about anxiety, or even maybe depression where you’re stuck in rumination, somebody is having an experience. We call it a private event like feeling, thought, belief that hurts, whatever it is. And what they’re doing is everything that they can to get away from that. So, if it’s OCD, there’s a scary thought or feeling, and then there’s a ritual that you do. 

So, to fix that, it’s all about learning to turn towards and approach that thing that’s hard. And there’s different ways you can do that. You can do that in a way where you’re dialing it in and you’re like, “Yeah, I’m going to do the thing,” but you’re doing everything that you can to not feel while you’re doing that. And I think that’s sometimes where people get stuck doing straight-up exposure and response prevention. It’s also hard. 

When I was a little kid, I was really scared to go off the high dive. I tell my clients and my team the story sometimes where it was like a three-meter dive. And I was that kid where I would be like, “I’m going to do it. All the other kids are doing it.” And I would climb up, I’d walk to the end of the board, freak out, walk back, climb down. And I did this so many times one day, and there’s a long line of other kids waiting to get in the water. And they were pissed. So, I got up and I walked out to the end of the board and I was like, “I can’t.” And I turned around to go back. And there was my swim coach at the other side of the board with his arms crossed. I was like, “Oh no.”

Kimberley: “This is not the way I planned.”

How do you apply Acceptance & Commitment Therapy for OCD and Mental Compulsions? 

Lisa: And he is like, “No, you’re going.” And I went, which was amazing. And sometimes you do need that push. But the point is that it’s really hard to get yourself to do those really hard things sometimes when it matters. So, to me, ACT brings two pieces to the table that are really, really important here. You can divide ACT into two sets of processes. There’s your acceptance and mindfulness processes, and then there’s your commitment and valuing processes, which are the engine of ACT, how do we get there? 

So, for the first part, mindfulness is really paying attention on purpose. And if you want to really learn from an exposure, you have to be in your body, you have to be noticing, you have to be willing to allow all of the thoughts and sensations and whatever shows up to show up. And so, ACT is ideal at shaping that skillset for when you’re in the exposure. So, that’s how we think of it that way. 

And then the valuing and commitment is, how do you get yourself off that diving board? There has to be something much more important, bigger, much bigger than your fear to help motivate you for why to do this hard thing. And I think that the valuing piece and really connecting with the things that we most deeply care about is part of what helps with that too. So, I think those two bookends are really, really important. There’s other ways to think about it, but those are the two primary ways that we do ERP, but we do it within an ACT framework.

Using Values to manage Mental Compulsions

Kimberley: Okay. I love this. So, you’re talking about we know what we need to do. We know that rumination isn’t helpful. We know that it creates pain. We know that it keeps us stuck. And we also know, let’s jump to like, we know we have to drop it ultimately. What might be an example of values or commitments that people make specifically for rumination, the solving? Do you have any examples that might be helpful? 

Lisa: Yeah. I’m just thinking of-- there’s a bunch of them, but for example, let’s take, for example, ROCD, relationship OCD. So, let’s say someone’s in a relationship with a partner and they’re not sure if the right partner is. Are they cheating on me? Are they not? Blah, blah, blah, blah. And it’s this like, “But I have to solve if this is the right person or not. Am I going to be safe?” or whatever the particular worry is. And so, one of the things that you can do is once folks notice, they’re trying to solve that. Notice, what’s the effect of that on your actual relationship? How is that actually working? So, there’s this stepping back where an ACT, we would call that diffusion or taking perspective self-as-context, which is another ACT, acceptance, and mindfulness piece. And first of all, notice that. Second of all, pause. Notice what you’re up to. Is the intent here to build a strong relationship, or is the intent to make this uncertainty go away? And then choose. Do I want to work on uncertainty or do I want to work on being a loving partner and seeing what happens? Because there’s so much we’re not in charge of, including what we’re thinking and feeling. But we are in charge of what we choose to do. And so, choosing to be present and see where it goes, and embracing that uncertainty. But the joyfulness of it, I think, is really, really important. So, that would be one example. 

Kimberley: I love that example. Actually, as you were saying, I was thinking about an experience of my own. When your own fears come up around relationship, even you’re ruminating about a conversation or something, you’ve got to stop and be like, “Is this getting in the way here of the actual thing?” It’s so true. Tell me about this joy piece, because it’s not very often you hear the word joy in a conversation about mental compulsions. Tell me about it.

Lisa: Well, when you start really noticing how this is working, and if you’re willing to step back from it, let it be, and stay where you are in that uncertainty, all sorts of new things show up. Stuff you never could have imagined or never could have dreamed. Your whole life could be just popping up all of these possibilities. In that moment you stop engaging with those compulsions, you could go in a hundred different directions if you’re willing to let the uncertainty be there. And I think that that’s really important. 

I want to tell a story, but I have to change the details in my head just for confidentiality. But I’m thinking of a person who I have worked with, who would be stuck and ruminating about, is this the right thing? I could make decisions and how do I-- for example, how do I do this lecture? My slides need to be perfect and ruminating, ruminating, ruminating about how it works. And one day they decided, “Okay, I’m just going to be present and I’m just going to teach.” And they taught with a partner. And the person themself noticed like, “Wow, I felt so much more connected to my students. This was amazing.” And the partner teaching with them was like, “I’ve never seen you so on. That was amazing.” They contacted this joy and like, “This is what it could be like.” And it’s like this freedom shows up for you. And it’s something that we think we know. And OCD loves to know, and it loves to tell you, it knows the whole story about everything. And it’s more what you get back when you stop doing the compulsions if you really, really choose that. It’s so much more than just, “Oh, I’m okay. I noticed that thought.” it’s so much more than that. It’s like, yes, and you get to do all this amazing stuff. 

Kimberley: Right. I mean, it’s funny. I always have my clients in my head. When someone says something, I’m imagining my client going, “But like, but like...” What’s the buts that are coming?

Lisa: And notice that process. But see, that’s it. That’s your mind, that’s their minds jumping back in being like, “See, there it is again.”

Kimberley: Yeah.

Lisa: And what if we just don’t know?

Using Curiosity to Stop Mental Compulsions 

Kimberley: And this is what I love about this. I agree with you. There have been so many times when I’ve dropped myself out of-- I call it being heady and I drop into my body and you get this experience of being like, “Wow.” For me, I can get really simple on like, “Isn’t it crazy that water is clear?” I can go to that place. “Water is clear. That is incredible.” You know what I mean? It’s there to go to that degree. But then, that’s the joy in it for me. It’s like, “Wow, somebody literally figured out how to make this pen work.” That still blows my mind. 

Lisa: I had a moment. I started horseback riding again for the first time in literally-- I’ve ridden on and off once a year or something, but really riding. And actually, it was taking classes and stuff for the first time in 30 years. And they put me in this class and I didn’t know what level it was. I just thought we were just going to walk around and trot and all that stuff. Plus, she starts setting up jumps. And I was like, “Oh my God, this is old body now. This is not going to bounce the way it might have been.” It’s what means all these 15-year-olds in the class.

Kimberley: Wow.

Lisa: I’m third in line and I’m just on the horse absolutely panicking and ruminating like, “Oh my God, am I going to die? Should I do this? What am I going to do? Should I tell her no? But I want it and I don’t know what I’m going to--” and my head was just so loud. And so, the two girls in front of me go. And then I look at the teacher and I go, “Are you sure?” It’s literally the first time I’ve ever done in 30 years. She just went-- she just looked at me. And I noticed that my legs squeezed the horse with all of the stuff rolling around in my head. And I went over the jump and it was, I didn’t die. It was really messy and terrifying. Oh my God, it was so exciting and joyful. And I was so proud of myself. That’s what you get--

Kimberley: And I’ve heard that from so many clients too. 

Lisa: It’s so awesome. 

Kimberley: I always say it’s like base jumping. It’s like you’ve got to jump. And then once you’ve jumped, you just got to be there. And that is true. There is so much exhilaration and sphere that comes from that. So, I love that. What about those who base jump or squeeze the horse and they’re dropping into discomfort that they haven’t even experienced before, like 10 out 10 stuff. Can you walk me through-- is it just the same? Is it the same concept? What would you advise there?

Lisa: So, I think it’s important to notice that when that happens, people are not just experiencing physical sensations and emotions, but it’s also whatever their mind is telling them about it. And I think this is another place where ACT is super helpful to just notice, like your mind is saying, this is 10 out of 10. What does that mean to you? That means like, oh my gosh. And just noticing that and holding it lightly while you’re in that 10 out of 10 moment, I think, is really, really helpful. 

So, for example, I have a really intense fear of heights where I actually freeze. I can’t actually move when I’m on the edge of something. And I had a young client who I’ve worked with for a while. And as an exposure for her, but also for me as her clinician to model, we decided. She wanted me to go rock climbing with her, which is not something I’ve ever done, ever, and also fear of heights. So, I kept telling myself, “Fear of heights, this is going to suck. This is going to be terrible. This is going to be terrible.” And there was also another part of me interested and curious. 

And so, what I would say when you’re in that 10 out of 10 moment, you can always be curious. So, when you’re like, “Oh my gosh, I’m really scared,” the moment you’re unwilling to feel that is the moment it’s going to overwhelm you. And if you can notice it as a thought, “I’m having the thought, I don’t think I can handle this. I don’t think I’m going to survive this,” and notice it and be curious, let’s see what happens. And so, for me, I noticed interestingly, even though I’m terrified of heights, I wasn’t actually scared at all. And that was a shocker, because I was full sure it was going to be the worst thing ever. 

And so, notice the stories your mind tells you about what an experience is going to be and stay curious. You can always be curious. And that’s going to be, I think, your number one tool for finding your way through and how to handle those really big, unexpected, and inevitable surprising moments that happen in life that are really scary for all of us.

Kimberley: Right. And when you say curious, I’m not trying to get too nitpicky on terms, but for me, curiosity is, let’s experiment. I always think of it like life is a science experiment, like let’s see if my hypothesis is true about this rock climbing. Is there a way that you explain curiosity?

Lisa: Yeah. Well, that’s part of it, but it’s also part like what you were describing. Isn’t water cool? It’s more than, is this true or not true? That’s so narrow. You want, “No, really? What does this taste like?” And that’s the mindfulness piece. Really notice all of it. There’s so much. And when you start doing that, you’ll find-- even if you do it outside of exposure, for example, as practice, you start to notice that the present moment is a little bit like Hermione’s purse in Harry Potter, where you think it’s this one thing, and then when you start to expand your awareness, you notice there’s tons of cool stuff. So, in these big, scary moments, what you might see is a sense of purpose or a sense of, “Holy crap, I’m handling this and I didn’t think I could. Wow, this is amazing,” or “I’m really terrified. Oh my gosh, my nose itches.” It could be anything at all. 

But the bottom line is, our bodies were meant to feel and they were meant to experience all the emotions. And so, there is no amount of emotion or fear or anything that we are not built to handle. Emotions are information. And to stay in the storm when it’s such a big storm, when OCD is ramping you up, it teaches the OCD, “Actually, I guess I get to stand down here eventually, I guess I don’t need to freak out about this so much. Huh, interesting. I had no idea.” I don’t know if that’s helpful or not.  

Kimberley: No, it’s so helpful. It is so helpful because I think if you have practiced curiosity, it makes sense. But for someone who maybe has been in mental compulsions for so long, they haven’t really strengthened that curiosity muscle.

Mindfulness for Mental Compulsions

Lisa: That’s so true. So, start small. Don’t start in the storm. Start with waking up in the morning and noticing before you open your eyes, what do you hear? How do the covers feel? Do you hear the birds outside your window? Start with that. And start in little moments, just practicing during the day. Start a conversation with someone you care about, and notice what your mind is saying in response to them, what it’s like to notice their face. Start small, build it up, and then start practicing with little tiny, other kinds of discomfort. Sometimes we’ll tell people like impatience. When you’re waiting in line or in hunger or tiredness, any of those, to just bring your full awareness to that and be like, “What is it like inside this moment right now?” And then you can extend that to, “Okay. So, what if we choose to approach this scary thing? What if we choose to just for a few seconds, notice what it feels like in this uncertain space?” And that’s how you might begin to bring it to rumination, be curious about what was the triggering thought. And then before you start ruminating or before you start doing mental rituals, just notice the first thought, and then you don’t have to answer that question. And there’s different ways to handle that, but curiosity is the beginning. And then stopping the compulsion is ultimately, or undoing it or undermining it in some way is going to be the other important piece.

Kimberley: I’d love to hear more about commitment. I always loved-- when I have multiple clients, we joke about this all the time. They’ll say, “I had these mental compulsions and you would be so proud. I was so proud. I was able to catch it and pull myself back into the present. And yes, it was such a win. And then I had another thought and you’d be so proud of me. I did the same thing. And then I had another thought and...”

Lisa: You’re like, “Was that the show that you just did right there?” It’s sneaky, huh.

Kimberley: And so, I’d love to hear what you’re-- and maybe bring it from an ACT perspective or however you would. It’s like you’re chugging away. “I’m doing good. Look at me go.” But OCD can be so persistent.

Lisa: It’s so tricky. 

Kimberley: And so, is that the commitment piece, do you think? What is that? How would you address that? 

Lisa: So, if I’m getting your question right, you’re asking about, what do we do when OCD hijacks something that you should do and turns it into a ritual? Is that what you’re asking? 

Kimberley: Yes. Or it just is OCD turns up the volume as like, “No, no, no, no. You are going to have to tend to me or I’m not going to stop,” kind of thing.

Lisa: Yes. That is a commitment piece. And it’s funny because there’s different ways that I think about this, but it’s almost like a little child who has a tantrum. If you keep saying yes, every time they make the tantrum bigger, it’s going to end up being a pretty big tantrum. And OCD loves nothing more than a good tantrum.

Kimberley: So true.

Lisa: And so, the thing you have to do is plan for that and go, “Yeah, it’s going to get loud. Yeah, it’s going to say whatever it needs to say, and it’s going to say the worst thing I can think of.” And I have had my clients call this all sorts of different things like first-order thoughts, second-order thoughts, just different variations on the theme where it’s going to ramp up to hook you in. And so, really staying very mindful of that and making a promise to yourself. 

One of my clients who helped us a lot in teaching but also in writing stuff that’s loud, Ethan, I think said it in this really elegant way. He said, make a promise to yourself. That really matters, even if it’s small. It doesn’t matter how big it is. But one of his first ones was, under no circumstances, am I going to do X the compulsion? And keep that promise to yourself because if you-- anybody who ever woke up and didn’t want to get out of the bed in the morning because, “Ah, too tired, it’s too early. I don’t really want to go to the gym.” If you know you’re in that conversation with yourself about, “Well, maybe just one more minute,” you’ve already lost. And so, this is a good place again for that ACT piece of diffusion. Noticing your mind or your OCD or your anxiety is pulling you into, “Ah, let’s just see if we can string you along here.” And so, what needs to happen is just move your feet and put them on the floor. Don’t get into that conversation with yourself. And having that commitment piece, that promise to myself with the added value piece, that really matters.

And one other thing that’s sometimes helpful that I have-- I’ll use this myself, but I also teach my clients, remembering this question: If this is a step towards whatever it is that’s really important, am I willing to allow myself to feel these things? Am I willing? And remembering that as a cue. We’re not here. It’s never about this one exposure. It’s about, this is a step towards this other life that you are fighting for. And every single step is an investment in that other life where you’re getting closer and you’re making it more possible, and just remembering that. I think that that’s a really important piece.

A Values Tool YOU NEED! 

Kimberley: Yeah. It actually perfectly answered the question I had, which is, you’re making a commitment, but what to? And it is that long-term version of you that you’re moving towards or the value that you want to be living by. Would you suggest-- and I’ve done a little bit of work on the podcast about values. Maybe one day we can have you back on and you can share more about that, but would you suggest people pick one value, three values? How might someone-- of course, we all have these values and sometimes OCD can take things from us, or anxiety can take those things from us. How would you encourage someone to move in that direction?

Lisa: Well, actually, do you want to do a fun thing?

Kimberley: I do.

Lisa: Okay. So, let’s do--

Kimberley: I never would say no to that. I would love to. I’m really curious about this fun thing.

Lisa: All right. So, do you like coffee or are you a tea person or neither?

Kimberley: Let’s go tea. I’m an Australian. If I didn’t say tea, I would be a terrible Aussie. 

Lisa: They’ll kick you off. All right. So, Kim, think about in your life a perfect cup of tea, not just a taste, but a moment with someone maybe you cared about or somewhere that was beautiful or after something big or before something big, or just think about what was a really, really amazing important cup of tea that you’ve had in your life.

Kimberley: Oh, it’s so easy. Do I tell you out loud? 

Lisa: Yeah. If you want to, that’d be great. 

Kimberley: I’ll paint you guys a picture. So, I live in America, but my parents live in Australia and they have this beautiful house on a huge ranch. I grew up on a farm. And we’re sitting at their bay window and you’re overlooking green. It’s just rolling hills. And my mom is on my left and my dad is on my right. And it’s like milky and there’s cookies. Well, they call them biscuits. So, yeah. That’s my happy place right there.

Lisa: And I could see it in your face when you’re talking about it. So, where do you-- does that tell you something about what’s really important to you? 

Kimberley: Yes.

Lisa: What does it tell you?

Kimberley: Family and pleasure and just savoring goodness, just slowing down. It’s not about winning a race, it’s just about this savoring. And I think there’s a lot-- maybe something there that I think is important is the green, the nature, the calm of that.

Lisa: Yeah. So, as you talk about that, what are you noticing feeling?

Kimberley: Oh my God, my heart just exploded 12 times. My heart is filled. That was the funnest thing I’ve ever done in my whole life. Funnest is not a word.

Lisa: What if you could build your life around moments like that? Would that be a well of life for you?

Kimberley: I think about that nearly every time I make tea, actually.

Lisa: That’s how you would help your clients, and that’s one way to think about values.

Kimberley: Wow. That is so cool. I feel like you just did a spell on me or something.

Lisa: You just connected with the stuff that’s really important. So, when you think about if I had a hard thing to do, what if it was a step towards more of that in your life?

Kimberley: Yeah.

Lisa: You see? 

Kimberley: It’s so powerful. I’ve never thought that. Oh my God, that was gold. And so, that’s the example. Everyone would use that, coffee or tea.

Lisa: There you go. Just think about it. And it’s funny because we came up with this in our team, maybe three months ago. We keep piloting just new little values exercise, but it’s so funny how compelling it is. just thinking about-- gosh. Anyway, I could tell you about mine, but you get the point. 

Kimberley: And you know what’s so funny too and I will say, and this is completely off topic, there’s a social media person that I follow on Instagram. And every time she does a live-- and for some reason, it’s so funny that you mentioned this, I love what she talks about, but to be honest, I’m not there to watch her talk. The thing that I love the most is that she starts every live with a new tea and she’ll pause the water in front of you. It’s like a mindfulness exercise for me. To be honest, I find myself watching to see whether she’s making tea. Not that this is about tea, but I think there’s something very mindful about those things that where we slow down-- and the water example, she’s pouring it and she’s watching the tea. And for some reason, it’s like a little mini-break in the day for me. 

Lisa: I totally agree. It’s like the whole sky, the cloud, and the tea and the--

Kimberley: Like Thich Nhat Hanh.

Lisa: Yes. I can’t remember the quote, but exactly. 

Kimberley: Yeah. Oh my gosh, I love that example. So good. Well actually, if you don’t mind, can you tell us your tea? Because I just would love to see if there’s a variation. So, what would yours be?

Lisa: It was funny because I think I did coffee the first time I did this, but then recently I just did a workshop in Virginia and I was like, “Oh my gosh, tea.” And what came to mind was, when I took my 17-year-old daughter tracking in the Himalayas to Nepal, because I wanted her. She was graduating from high school and I wanted to show her that you could do anything and she really wanted to go. We both really wanted to go to Ever Space Camp. And every morning after trekking nine, 10, 11 hours a day where you’re freezing cold, you’re exhausted, everything’s hurting, and it’s also amazing and beautiful, the guides would knock at our door and there would be two of them. And one of them would have a tray of little metal cups. And then the other one would say, “Tea? Sugar? Would you like sugar?” And they would make you, they would bring you, and this was how you woke up every morning, a steaming cup of tea. Sometimes the rooms were 20 below zero. And you’d get out of bed and you’d be so grateful for that warm cup of tea. And that was the tea I remembered.

Kimberley: Right. And then the values you pulled from that would be what?

Lisa: That moment, it was about being with my daughter and it was about showing her, modeling courage and modeling willingness and just adventure and this love of being in nature and taking a journey and seeing, “Could we do this? And what would it be like?” And just sharing the experience with her. It’s just beautiful. And the tea is right in the center of that. So, it’s almost not even about the tea, but it’s that moment. It’s that time and that experience. So amazing.

Kimberley: So amazing. Thank you. I’m deeply grateful. That just filled my heart. 

Lisa: I’m so glad. I feel so honored that you have had experience. I love that so much.

Kimberley: I did. I always tell my clients or my kids or whoever is at-- when I was a kid, my mom, every afternoon when I came home from school, she’d say, “What’s the one thing you learn at school today?” And so still, there’s always one thing I learn and I always note it like that’s the one thing I learned today and that was it. What an amazing moment. 

Lisa: I’m so glad. 

Kimberley: Okay. I love this. So, we’ve talked about mindfulness and we’ve talked about commitment. We’ve talked about values and we have talked about the acceptance piece, but if we could have just one more question around the acceptance piece. How does that fit into this model? I’m wondering. 

Lisa: It’s funny because I always feel like that acceptance piece, the word, it means to so many people, I think, tolerance or coping or let’s just make this okay. And it doesn’t mean any of those things. And so, I’ve moved more into thinking of it and describing it as, it’s like a willingness. What is under the hood of acceptance and am I willing? Because you cannot like something and not want something and also be willing to allow it. And it’s almost like this-- again, it involves curiosity about it. It involves squeeze the horse with all the stuff. Get the feet on the floor, even though you’re having an argument that’s in your head. And so, sometimes people think about it as a feeling and sometimes it is, but a lot of times, it’s willingness with your feet. When you think about moms and infants in the middle of the night, I don’t think there was ever a moment when I was like, “Oh yeah, the baby’s crying at 4:00 in the morning. I’m so excited to get up.” I’m feeling in my heart, no. It’s like you’re exhausted and it’s like the last thing you want to do and 100% you’re willing to do it. You choose. And so, that’s the difference. And so, I think people get tangled up, not just thinking of it as tolerance, but also waiting for a feeling of willingness to happen. And that’s not it. It’s a choice.

Kimberley: It’s gold.

Lisa: Yeah, seriously. I mean, it’s the same thing. I learn it every day. Trust me, when I fall out of my gym routine or my running routine and I’m off the willingness, and then I’m like, “Yeah, that’s not it.” And I have to come back to it. So, it’s something we all struggle with. And I think that’s really important to know too, but ultimately, it’s a choice, not a feeling.

Kimberley: Okay. That was perfect. And I’m so happy. Thank you, number one. This is just beautiful for me and I’m sure the gifts just keep going and flowing from this conversation. So, thank you. 

Lisa: Thank you for having me.

Kimberley: Tell me where people can hear more about you and know your work?

Lisa: Well, we’re at the New England Center for OCD and Anxiety in Boston. We have recently opened in New York City and in Ireland. So, if anybody is in Ireland, call us, look us up.

Kimberley: Wow.

Lisa: Yeah. That’s been really fun. And there’s a few books we have. There’s Stuff That’s Loud written by Ben Sedley and myself. There’s our newest book called Stop Avoiding Stuff with Matt Boone and Jen Gregg. And that’s a fun little book. If anybody’s interested in learning about ACT, it’s really written-- the chapters are each standalone and they’re written so that you could read them in about two minutes, and that was on purpose. We wanted something that was really pocket-sized and really simple with actionable skills that you could use right away. And then I have a new book coming out actually really soon. And no one knows this. Actually, I’m announcing this on your show. And I am writing it with my colleague, Sarah Cassidy-O’Connor in Ireland. We are just doing the art for it now and it’s a book on ACT for kids with anxiety and OCD. 

Kimberley: When is this out?

Lisa: Good question. I want to say within the year, but I don’t remember when.

Kimberley: That’s okay. 

Lisa: But look for it and check out our website and check out Stuff That’s Loud website. We’ll post it there and let folks know. But yeah, we’re really excited about it. And it’ll be published by a UK publisher. So, it’s really cute. So, I think the language will be much more like Australia, UK, Ireland for the US, which is really fun because I have a connection to Ireland too. But anyway, there you go. 

Kimberley: It’s so exciting. Congratulations. So needed. It’s funny because I just had a consultation with one of my staff and we were talking about books for kids. And there are some great ones, but this ACT work, I think as I keep saying, there’s skills for life. 

Lisa: It really is.

Kimberley: So important. How many times I’ve taught my child, even not related to anxiety, just the ACT skill, it’s been so important.

Lisa: Yeah. Mine too. I think they’re so helpful. They were just really helpful with flexibility in so many different areas.

Kimberley: Right. I agree. Okay. This is wonderful. Thank you for being on. Like I said, you brought it home. 

Lisa: We’ll have our cups of tea now.

Kimberley: We will

Lisa: So nice to talk to you, Kim. 

Kimberley: Thank you.

Lisa: Thank you.

May 27, 2022

SUMMARY:

In this week's podcast, we talk with Dr. Reid Wilson.  Reid discussed how to get the theme out of the way and play the moment-by moment game.  Reid shares his specific strategies for managing mental compulsion. You are not going to want to miss one minute of this episode.

Covered in This Episode:

  • Getting your Theme out of the way
  • The importance of shifting your additude
  • Balancing “being aggressive” and implementing mindfulness and acceptance
  • How to play the “moment by moment” game
  • Using strategy to achieve success in recovery
  • OCD and the 6-moment Game
  • Other tactics for Mental compulsions

Links To Things I Talk About:

Reid’s Website anxieties.com
https://www.youtube.com/user/ReidWilsonPhD?app=desktop
DOWNLOAD REID’s WORKBOOK HERE 

Episode Sponsor:

This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more.

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Managing Mental Compulsions (With Dr. Reid Wilson) Your anxiety toolkit

EPISODE TRANSCRIPTION

This is Your Anxiety Toolkit - Episode 286.

Welcome back, everybody. I am so excited. You guys, we are on number five of this six-part series, and this six-part series on Managing Mental Compulsions literally has been one of the highlights of my career. I am not just saying that. I’m just flooded with honor and pride and appreciation and excitement for you. All the feedback has been incredible. So many of you have emailed me or reached out to me on social media just to let me know that this is helping you. And to be honest with you, I can’t thank you enough because this has been something I’ve wanted to do for so long and I’ve really felt that it’s so needed. And it’s just been so wonderful to get that feedback from you. So, thank you so much.

The other plus people I want to be so grateful for are the guests. Each person has brought their special magic to how to manage mental compulsions. And you guys, the thing to remember here is managing mental compulsions is hard work, like the hardest of hard work. And I want to just honor that it is so hard and it is so confusing and it’s such a difficult thing to navigate. And so, to have Jon talking about mental compulsions and mindfulness and Shala talking about her lived experience and flooding, and Dr. Jonathan Grayson talking about acceptance last week. And now, we have the amazing Reid Wilson coming on and sharing his amazing strategies and tools that he uses with his patients with mental rumination, mental compulsions, mental rituals. Literally, I can’t even explain it. It’s just joy. It’s just pure joy that I get to do this with you and be on this journey with you.

I’m going to do this quick. So, I’ll just do a quick introduction. We do have Dr. Reid Wilson here. Now we’ve had Reid on before. Every single guest here, I just consider such a dear friend. You’re going to love this episode. He brings the mic drops. I’m not going to lie. And so, I do hope that you squeeze every little bit of juice out of this episode. Bring your notepad, get your pen, you’re going to need it, and enjoy. Again, have a beautiful day. As I always say, it is a beautiful day to do hard things. Let’s get onto the show.

Kimberley: I am thrilled to have you, Dr. Reid Wilson.

Reid: Thanks. Glad to be here.

Kimberley: Oh my goodness. Okay. I have been so excited to ask you these questions. I am just jumping out of my skin. I’m so really quite interested to hear your approach to mental compulsions. Before we get started, do you call them mental compulsions, mental rituals, mental rumination? How do you--

Reid: Sure. All of the above doesn’t matter to me. I just don’t call it “pure obsessions, pure obsessionals” because I think that’s a misnomer, but we can’t seem to get away from that.

Kimberley: Can you maybe quickly share why you don’t think we can get away from that? Do you want to maybe-- we’d love to hear your thoughts on that. We haven’t addressed that yet in the podcast.

Reid: Well, typically, we would call-- people write to me all the time and probably do that too, say, “I’m a pure obsessional.” Well, that’s ridiculous. Nobody’s a pure obsessional. What it really is, is I have obsessions and then I have mental compulsions. And so, it’s such a misnomer to be using that term. But what I mean is, how we can’t get away from it is it’s just gotten so completely in the lexicon that it would take a lot of effort to try to expel the term.

Getting the theme out of the way

Kimberley: Okay. Thank you for clearing that up, because that’s like not something we’ve actually addressed up until this time. So, I’m so grateful you brought that up. So, I have read a bunch of your staff. I’ve had you on the show already and you’re a very dear friend. I really want to get to all of the main points of your particular work. So, let’s talk first about when we’re managing mental compulsions. We’ll always be talking about that as the main goal, but tell me a little bit about why the theme, we’ve got to get out of the way of that.

Reid: Right. And my opinion is this is one of the most important things for us to do and the most difficult thing to accomplish. It’s really the first thing that needs to be accomplished, which is we have to understand. And you’re going to hear me say this again. This is a mental health disorder and it’s a significant disorder. And if we don’t get our minds straight about what’s required to handle it, we’re going to get beaten down left and right. So, of course, the disorder comes into the mind as something very specific. Focusing on the specific keeps us in the territory of the disorders control. So, we need to understand this is a disorder of uncertainty. This is a disorder of uncertainty that brings distress. So, we have that combination of two things. If we’re going to treat the disorder, we cannot bring our focus on our theme. But the theme is very ingrained in everyone. 

I talk about signal versus noise, and this is how I want to help people make that transition, which is of course, for all of us in all humanity, every worry comes into the prefrontal cortex as a signal. And we very quickly go, “Oh yeah, well, that’s not important. I don’t need to pay attention to that.” And we turn it over to noise and let go of it and keep going. With OCD, the theme, the topic, the checking, and all the mental rituals that we do are perceived and locked down as signals. And if we don’t convert them into noise, we are stuck. 

What I want the client to do is to treat the theme as nothing, and that is a big ask. And not only do we have to treat the theme as nothing, we have to treat it as nothing while we are uncertain, whether it’s nothing or not. So, in advance of an obsession popping up, we really need to dig down during a no problem time and get clear about this. And then we do want to figure out a way to lock that down, which includes “I’m going to act as though this is nothing,” and it has to be accomplished like that. Go ahead.

Kimberley: No. And would you do the same for people, let’s say if they had social anxiety or health anxiety, generalized anxiety? Would you also take the theme out of it?

Reid: Absolutely. But if the theme is in the way, then we need to problem-solve that. So, if we go to health anxiety, okay, I’ve got a new symptom, some pain in the back of my head that I’ve never had before. I have to decide, am I going to go into the physician and have it checked out or am I not? Or am I going to wait a few days and then do it? With that kind of anxiety and fear around health, we have to get closure around “I don’t need to do anything about this.” Sometimes I use something called “postponing.” So, with social anxiety, it can-- I mean, with health anxiety, it can work really well to go, “Well, I’m having this new symptom, do I have to immediately go in and see the physician and get it checked out? Can I wait 24 hours? Yes, I can. I’ve already been diagnosed with health anxiety. So, I know I get confused about this stuff. So, I’m going to wait 24 hours.” So, what does that give us then? Now I have 24 hours to treat the obsession as nothing because I don’t need to focus on it. I’ve already decided, if I’m still worried tomorrow, I’m making an appointment, we’re going in. That gives me the opportunity to work on this worry as an obsession because I’ve already figured it out. The reason we want to do that so diligently is we have to go up one level of abstraction up to the disorder itself. And that’s why we have to get off of this to come up here and work on this.

Kimberley: This is so good. And you would postpone, use that same skill for all the themes as well? I’m just wanting to make sure so people clarify.

Reid: Well, sure. I mean, postponing is a tactic. I wouldn’t say we can do postponing across the board because some people have-- it really depends on what the obsession is and what the thinking ritual is as to whether we can use it. But it’s one of them that can be used.

Shifting your attitude 

Kimberley: Amazing. Tell me about-- I mean, that requires a massive shift in attitude. Can you share a little bit about that?

Reid: Yeah. And if you think about-- I use that term a lot around attitude, but we’ve got some synonyms in attitude. What is my disposition toward this? Have I mentioned mental health disorder? What do I want my orientation to be? How do I want to focus on it? And we want to think about really attitude as technique, as skill set. So, what we know is the disorder wants some very specific things from us. It wants us to be frightened by that topic. It wants us to have that urge to get rid of it and have that urge to get rid of it right now. And so, that begins to give us a sense of what is required to get better. And that again is up here. 

So, why do you do mental counting? Why do you do rehearsal mentally? Why do you try to neutralize through praying? When you look at some of those, the functions of some of those or compulsions and urge to do the compulsions, it is to fill my mind so I don’t get distracted again, it is to reassure myself, it is to make sure everything is going to be okay. It is to get certain. And so, when we know that that is the drive of the disorder, we begin to see, what do we need to do broadly in general? And that is, I need to actually operate paradoxically. If it needs me to do this, feel this, think this, I’m going to do everything I can to manipulate that pattern and do the opposite. It wants me to take this theme seriously, I’m going to work on-- and really it has to be said like that. I’m going to work on not taking it seriously. So, that’s the shift. If we can get a sense of the attitude and the principles that go along with all of that, then moment by moment, we’ll know what to do in those moments.

Do you need to be aggressive with OCD and intrusive thoughts? 

Kimberley: We’ve had guests talking about mindfulness and we will have Lisa Coyne talking about act and Jon Grayson talking about acceptance, and you really talk more about being aggressive. How do you feel about all of those and where do they come together, or where are they separate? How would you apply these different tools for someone with mental compulsions?

Reid: Yeah, sure. Mindfulness is absolutely a skill set that we need to have. Absolutely. We are trying to get perspective. We’re trying to get some distance. We would like to detach. That’s what we’re trying to do. But what are we trying to be mindful of? We’re trying to be mindful of the belief that this topic is important. We’re trying to be mindful of the need to ritualize that is created by the theme. So, the end game is mindfulness and detachment. That’s where we’re going. My opinion is, the opening gambits, the opening moves, it’s very difficult to go from a frightened, terrified, scared, and slide over to neutral and detached. It’s just difficult. 

And so, I think initially, we need to be thinking about a more aggressive approach, which is I’m going to go swing in this pendulum from, “I can’t stand this, this is awful.” I’m going to swing over right past mindfulness over to this more aggressive stance of, “I want this, let’s get going. I’m taking this theme on.” The aggressiveness is a determination of my commitment to do the work. 

And here’s the paradox of it. I’m going to address on the disorder by sitting back. My action is to go, “I’m okay. This is all right.” And that’s a mindful place to get to. But you have to know we’re going after this big, aggressive bully, and it requires an intense amount of determination and you have to access your determination over and over and over again. You don’t just get determined and it’s steady. So, we just got to keep getting back to that. “No, no, I want to do this work. I want to get my outcome picture. I want to have my mind back. I want to go back to school. I want to be able to connect with my family in a loving way, with having one-third of my mind distracted. I want that back very strongly. And therefore, If I have to go through this work to get there, I want to go through this work.” We can maybe talk more about what that whole message of “I want this” means, but here it is, which is, “I want this” is a kind of determination that’s going to help drive the work.

Kimberley: Yeah. Let’s go there because that is so important. So, tell me about “I want this.” Tell me about why that is so important. So, you’ve talked about “I want to get better and I want to overcome this,” and so forth. Tell me more about the “I want this comfort.”

Reid: Well, let’s think about-- you really only have two choices in terms of your reaction to any present moment, either I want this moment, so I’m present to this moment, or I don’t want this moment. It’s very simple in that way. When I don’t want this moment, I’m now resisting this present moment. And what that means practically speaking is, now I’ve taken part of my consciousness, part of my mind that is available for the treatment and I’ve parked it. I’ve taken it offline and actually provoking myself, sticking myself with, “Are you sure you want to do this? Is this really safe? Don’t you think-- maybe we could do this later and not now.” So, there’s a big drive to resist that we need to be aware of. Have I mentioned this yet? This is a mental health disorder that is very tough to treat. I want 100% of my mental capacities available to do the treatment. I’ll never have all of that because I’m always going to have some form of resistance, but I need to get that resistant part of me on the sideline not messing with me, and then let me go forward all like that. 

One of the confusions sometimes people get around this work when I talk about it is it’s not, “Oh, I want to have another obsession right now,” or “I want to have an urge to do my compulsion right now. I want that.” No. What we’re talking about is a present moment. So, if my obsession pops up, if it pops up, I want it. If I’m having that urge to do my compulsion, I want it. And why is that? Because we have to go through it to get to the other side. I have to be present to both the obsessions and the urges to do the compulsions in order to do the treatment. So, that’s the aggressive piece. “Come on, bring it on. Let’s get going. I’m scared of this.” Of course, I don’t want--

Kimberley: I’m just going to ask.

Reid: I don’t want to feel it. I don’t want to, but I’m clear that to do the treatment, it requires me to go through the eye of the needle. If you’re like I am, there’s plenty of days when you don’t want to go to the gym. You don’t really want to work out or sometimes you don’t even want to go to bed as early as you should, but if we want the outcome of that good rest, that workout, then we manifest that in the moment and get moving.

We’re disrupting a pattern. When I talked about postponing, it’s a disruption of this major pattern. If we insert postponing into these obsessions and mental compulsions are impulsive, I have that obsession and I pretty immediately have that urge to do the compulsion. And then I begin doing my mental compulsion. If we slide something in there, that’s what mindfulness does go, “Oh, there it is again. Oh, I’m doing it.” Even if you can’t sustain that, you’ve just modified for a few moments, the pattern that you’ve had no control over. So, that’s where we want to be going. And you know how I sometimes say it is, my job is to-- as the client is to purposely choose voluntarily to go toward what scares the bejesus out of me. I don’t know if you have bejesus over there in California, but in North Carolina, we got bejesus, and you got to go after it.

Kimberley: I think in California, it’s more of a non-kind word.

Reid: Ah, yes. Okay. Well, we won’t even spell it.

The Moment By Moment Game 

Kimberley: That’s okay. So, I have questions. I have so many. When you’re talking about this moment, are you talking about your way of saying the moment-by-moment game? Is that what you’re talking about? Tell me about the moment-to-moment game.

Reid: Sure. I’m sure people hearing this the first time would go, “Well, don’t be-- you’ve lost rapport with me now because you called it a game.” But I’ve been doing this for 35 years, so it’s not like I am not aware of the suffering that goes on here. The only reason to call it a game is simply to help structure our treatment approach.

Kimberley: That’s interesting, because I think of a game as like you’re out to win. There’s a score. That’s what I think of when I--

Reid: That’s what this is. That is actually what this is. 

OCD and the 6 Moment Game 

Kimberley: I don’t think of it as a game like Ring A Rosie kind of stuff. I think of it as like let’s pull our socks up kind of stuff. Is that what you’re referring to?

Reid: We’ve got this mental game that we are-- we’ve been playing this game and always losing. So, we’re already engaged in it. We’re just one down and on the losing end, on the victim end. So, when I talk about it as moment by moment, I want to have, like we’ve been talking about, this understanding of these sets of principles about what needs to happen. It wants me to do this, I’m going to do the opposite, this is paradoxical and so forth. And then we need to manifest it moment by moment. So, how do we do this? I will really talk about six moments and I’ll quickly go through the first three because the first three moments are none of our business. We can’t do anything about them. 

So, moment #1 is just an unconscious stimulus of the obsession, and that’s all. That’s all it is. Moment #2 is that obsession popping up. And moment #3 is my fear reaction to the obsession because obsessions are frightening by their construct. And so, now I’ve got those three moments. As I’m saying, we can’t do anything about those three moments. These three moments are unconsciously mediated. They are built right on into the neurology. 

Now we’ve got in my view three more moments. So, moment #4 is really the foundation of what we do now, what we do next, which is a mindful response. And it is just stepping back in the moment. Suddenly the obsession comes up and I’m anxious and I’m worried about it and I’m having the urge to do the compulsion. And what I want to train myself to do, which can take a little time sometimes, is when I hear my obsession pop up. The way I just described it right there is already a stepping back. When I recognize that I’ve started to obsess and sometimes it takes a while to even recognize it, I want to step back in that moment and just name it. They have that expression, “Name it to tame it.” So, it’s the start of that. So, I’m stepping back in that moment going, “Oh, I’m doing it again,” or, “Oh, there it is.”

Now, the way I think about it, if I can do that and just step back and name it, I just won that moment because I just inserted myself. I insinuated myself into the pattern. OCD doesn’t want you anywhere near this at this moment. It doesn’t want you to be labeling the obsession an obsession. It wants you to be naming the fearful topic of it. So, I’m going to step back in that moment. And if I can accomplish that, great, I’ve won that moment. 

If I can go further in that moment, of course, in the end, we want to be able to do that, moment #5 is taking the position of, “I’m treating this as nothing. There is my obsession. I’m treating it as nothing.” And there’s all kinds of things you can say to yourself that represent that. “This is none of my business. Oh, there it is trying to go after me. Not playing. I’m not playing this game.” Because it really is a game that the disorder has created. And what we’re saying is, “Look, I’m not playing your game anymore. I’m playing my game. And this is what my game looks like.” I’m going to notice it when it pops up, the obsession and the urge to do my compulsion, and I’m going to go, “Not playing,” whatever way I say it. 

And then moment #6, and this is a controversial moment for others. Moment #6, I’m going to turn away from it. I’m going to just redirect my attention, because this is nothing, but it’s drawing my attention. I’m going to treat it as nothing by engaging in some other thought or action that I can find. And even if I can refocus my attention for eight seconds, even if it pops right back up again like, “Where are you going? This is important. You need to pay attention to it,” even if I turn away for eight seconds, I’ve won that moment because I’m no longer responding to this over here. 

Now, why I say this is controversial for some folks is it sounds like distraction. It sounds like, “Oh, you’re not doing exposure. You’re just telling the person to distract themselves. And that’s opposite of what we want to be doing.” I don’t see it that way. 

Kimberley: No, I don’t either. I think it’s healthy to engage in life. 

Reid: And if we think about, what we’re really trying to do is to sit with a generic sense of uncertainty, then this allows us to do it because, in essence, the obsession is a kind of question that is urging you to answer. And when you turn away, engage in something else, you are leaving that question on the table. And that is exposure to pure uncertainty. I just feel like in our field, in exposure, we’re doing so much to ask people to expose themselves to the specifics and drill down about that as a way to change neurology. And we know that’s really the gold standard based on all the research that has been done. But I think it really adds a degree of distress focusing on that specific that maybe we can circumvent. 

Kimberley: Do you see a place for the exposure in some settings? I mean, you’re talking about being aggressive with it. Does that ever involve, like you said, staring your fear in the face purposely?

Reid: Well, yeah. And how do you do that? Well, what you do is you either structure or spontaneously step into circumstances that would tend to provoke the obsession. So, do something that I’ve been avoiding for fear that thought is going to come up or anything that I have been blocking or avoiding out of fear of having the obsession or anything that tends to provoke the obsession. I want to step into those scenes. So, step into the scene, but the next move isn’t like, “Okay, come on obsessions. I need to have an obsession now.” No. If you step into the scene that typically you have an obsession with and you don’t have the obsession, well, that’s cool. That’s fine. That’s progress. That’s great. Now you got to find something else to step into it with. However, most people with thinking rituals, it goes on most of the day anyway. So, we’re going to have a naturalistic exposure just living the day. 

Kimberley: The day is the exposure.

Reid: And for people who are structuring it and you know you’re about to step into a scene where you have the obsession, you can, in that way, be prepared to remind yourself, cue yourself ahead of time what your intention is. The more difficult practice is moving through your day and then getting caught by it. So, you get caught by it and then you start digging to fix the content and it takes a little more time to go, “Oh, I’m doing it again.” We’re doing exposure. This is exposure. You have to do exposure. I’m just saying that there’s a different way to do it instead of sitting down and conjuring up the obsession in order to sit with the distress of the specific.

Kimberley: I’m going to ask you a question that I haven’t asked the others, just because it’s coming up specifically for me. Some clients or some of my therapist clients have reported, “Okay, we’re doing good. We’re doing good. We’re not doing the mental compulsion.” And the obsession keeps popping up. “Come on, just a little. Come on, let’s just work it out.” And they go, “No, no, no, not engaging in you.” And then it comes back up. “No, no, no, not engaging in you.” And much of the time is spent saying, “Not today, not today,” or whatever terminology. And then they become concerned that instead of doing mental compulsions, they’re just spending the whole time saying, “Not today, not today.” And they’re getting concerned. That’s becoming compulsive as well. So, what would you say? Are you feeling like that’s a great technique? Where would you intervene if not?

Reid: Well, I think it’s fine if it is working like we’re describing it, which is not today, turning away, engaging in something else. So, we’ve got to be careful around this “not today” thing if you forget to do--

Kimberley: The thing

Reid: Moment #6, which is find something else to be engaged in. Then you’re going to be-- it’s almost, again, you’re trying to neutralize, “Oh, this is nothing.” So, we want to make sure that we really complete the whole process around that. And the other way that we-- again, mindfulness and acceptance, the way we can get to it is we have the expression of front burner and back burner. So, we want to take the obsessiveness and the urges and just move them to the back burner, which means they can sit there, they can try to distract you, they can try to pull your attention. So, here you are at work and you’re really trying to do right by the disorder, but you’re trying to work, and it’s still coming over here trying to get to you. You’re going to be a little distracted. You’re not going to be performing your work quite as well as you would if your mind were clear. And that is the risk that you need to take. That is the price that you need to pay. And that’s why you need to have that determination and that perspective to be able to say, “Geez, this is hard. This is what I need to be doing.” You have to talk to yourself. You have to. We talk to ourselves all day long. This is thinking, thinking, thinking. So, we know people with thinking rituals are talking about the urges and so forth. And we’ve got to redirect how we talk about it in the moment.

Kimberley: Okay. So good. What I really want to hear about is your ideas around rules. 

Reid: Sure. And again, nobody seems to talk about rules. I’m a very big component or a proponent of rules. And here’s one reason. What are thinking rituals all about? It’s all about thinking, thinking, thinking, thinking, thinking. What do we need to do in the treatment strategy? Well, first off, the disorder is compelling me to fill my mind with thoughts in order to feel safe. I need to come up with a strategy and tactics that reduce my thinking. Then if I don’t reduce my thinking, I’m not going to get stronger. One of the ways to reduce my thinking is to say, “I don’t need to think about this anymore. I’ve already figured out what I need to do.” So, during no problem times, during therapeutic times, whether you’re sitting with your therapist or figuring this out on your own, you come up with literally what we’ve been talking about, “What I need to do when an obsession takes place? And then here’s what I’m going to do next.”

Kimberley: So, you’re making decision--

Reid: I’m going to turn my attention. I’m sorry, go ahead.

Make Decisions Ahead of Time

Kimberley: Sorry. You’re making decisions ahead of time. Is that what you mean?

Reid: Absolutely. You’re making decisions. This is rules of engagement. So, we’re not talking about having to get really specific moment by moment. We’re talking about thinking rituals. So, it’s rules of engagement. Well, simply put, initially, the rule of engagement has to do with those six moments we talked about, which is, okay, when this pops up, this is how I’m going to respond to it. So, we want to have that. All that we’ve talked about decide that ahead of time. And then as I would say, lock it down, lock it down. And now the part of you who is victim to the disorder, when the obsessiveness starts again, when the urge to do the compulsion starts again, I want to have all of me stand behind the rules, because if we don’t have predetermined rules, what is going to run the day? What’s going to win the day? What’s going to win the day in the moment is the disorder shows up. The victim side, the victim to the disorder is also going to show up and it’s going to say, those rules that I was talking about before, “This seems like a bad idea. I don’t think in this circumstance that’s the right thing to do.” So, if we don’t lock it down and we don’t have a hierarchy, which is, what I was saying, we’re not killing off the side of us that gets obsessive and is being controlled by the disorder. But we are elevating the therapeutic voice, “I’ll do that again with my hands.” 

This is a zero-sum game. So, if I bring my attention to what I’ve declared what I need to do now, then by default, my attention toward that messages of my threatened self are going to diminish. And this is what I’ve been talking about with you around determination. You have to be so determined, because it’s so tantalizing. Even if they say this isn’t going to take me very long to complete this mental ritual, and then it’ll be off my plate, and I won’t have to be scared about the outcome of not doing this, why wouldn’t I do that? So, that’s what we’re really competing against in those moments of engagement.

Thinking Strategically

Kimberley: Right. So good. I’m so grateful for what you’re sharing. Okay. I want to really quickly touch on, and I think you have, but I want to make sure I’m really clear in terms of thinking strategically. It sounds like everything you just said is a part of that thinking strategic model. I love the idea that you come into the day, having made your decisions upfront with the rules. You’ve got a plan, you know the steps in the moment. Thinking strategically, tell me if that’s what that is or if there’s something we’ve got to add to it.

Reid: Yeah. So, yes, all that you just said is that, that we’re understanding the principles of treatment based on the principles of what the disorder has intended for us. And then we’re trying to manifest those principles in, how do we act in the moment? How do we engage in that in the moment? The other thing we want to think about in terms of how I think about strategic treatment is we’re looking for the pattern and messing with the pattern. So, I talked earlier about postponing. We insert postponing into the pattern. It’s much easier to add something to a pattern than to try to pull something away. So, if we add postponing or add that beat where I go, “Oh, there’s my obsession,” now we’re starting to mess with the pattern. I’ll give you a couple of-- these are really tactics. Let me tell you about a couple of others and these seem surprisingly ridiculous. Okay, maybe not surprisingly ridiculous. 

Kimberley: Appropriately ridiculous. 

Reid: I’m sure you experience this. I experience a lot where people go, “Look, I’d love to do what you’re saying, but these obsessions are just pounding away at me all day long. I can’t interrupt them. I can’t do it.” What I would like people to be focused on is, what can we do to make keeping the ritual, keeping the obsession more difficult than letting it go? So, we talked about postponing. That doesn’t quite do what I’m saying right now. One of the things I’ll have people do is to sing it. I know, and I’m not going to demonstrate.

Kimberley: Please. I will. 

Reid: And here’s what you do. If I can’t stop my obsessions, I can’t park them, then when I notice – there’s moment #4 – when I notice my obsessions-- and we can do this in a time-limited-- I’m a cognitive therapist, so we do behavioral experiment. So, we can just do an experiment. We can go, “Okay, for the next three days, three weeks, three hours, whatever we decide, anytime I notice the obsession coming up, instead of saying it urgently and anxiously in my mind, I must sing it.” It just means lilting my voice. “Oh my gosh, how am I ever going to get through this? I don’t count the tiles on the ceiling. I’m not sure I can really handle what’s going to happen next. Oh my gosh, I feel so anxious about--” you see why I don’t demonstrate.

Kimberley: Encore, encore.

Reid: SO, it’s just lilting the voice like that. A couple of things are going on. One is obviously we’re disrupting the pattern. But just as important, who in their right mind, having a thought that is threatening, would sing it? So, simply by singing my obsession instead of stating it, I’m degrading the content, I’m degrading the topic. And so, that’s why I would do it. And again, that’s what we were saying. You got to lock it down. You got to go signal versus noise. This is noise. It’s acceptable to me to be doing this. This is very difficult. With such a short period of time, I don’t drill that home as much as I might. This is really, really hard, but it is an intervention.

So, singing it is one thing that I will sometimes have some people do. And the other one is to write it down. And this means literally carrying a notepad with you and a pen throughout your day. And anytime your obsession starts to pop up, you pull that notepad out and you start writing your obsession. And I’m not saying put it in an organized paragraph fashion or a bulleted list or anything like that. We’re talking about stenographer in the courtroom. I want to, in that moment, when I start obsessing, to step back, pull out my notepad, because I said for the next three days, I’m going to do this, and then I’m going to write every single thing that’s popping up in my mind. 

Kimberley: So, it’d be like, “What if you want to kill her? You might want to kill her. There’s a knife. I noticed a knife. Do I want to kill her with a knife? Am I a bad person?”

Reid: Oh, it’s harder than that. It’s harder than that, Kimberley, because you’re not only saying, “Do I want to kill her? There’s the knife. Oh, what did I just say?” Now I got to write, “Oh, what did I just say? Oh, the knife. Oh, the knife. Do I want to kill her with the knife?” So, every utterance, we’re not saying every utterance. And so, there’s going to be a message of, “Did I just say that right? Now I can’t remember what I said. Damn it, damn it.” All of that. Now, again, a couple of things are happening. I’m changing modes of communication. The disorder wants me to do this by thinking. You and I know, you can have an obsessive thought a thousand times in a day. You can’t write it a thousand times. So, now we’re switching from the mode of communication that serves the disorder to a mode of communication that disrupts it. And if I really commit myself to writing this, after a while, now I’m at a choice point. Now when obsession pops up later and I go, “Oh, I’m obsessing again. Well, I can either start writing it,” or “Maybe I can just let it go right now because I don’t want to write it. It’s just so much work. Okay, let me go distract myself.” So, all of a sudden, we’ve done exposure and response prevention without the struggle, because I don’t want to do what I have agreed to do locked down, which is write this. 

So, it empowers. Writing it, just like singing it, empowers me to release it, especially people with thinking rituals. The whole idea of using postponing around the rituals, singing the obsession if I need to, writing down the obsession as tactics to help break things up, and then just keep coming back to what’s our intention here. This is a mental health disorder. I keep getting sucked into the topic. I don’t think I can-- here’s I guess the last thing I would say on my end is, this is it, which is, I don’t know if this is going to work. I don’t know how painful whatever is coming next is going to be by not doing my ritual. I am going to have faith. I mean, this is what happens. You have to have faith and a belief in something and someone outside of your mind, because your mind is contaminated and controlled by the disorder. You can’t keep going up into your thinking and try to figure out how to get out of this wet paper bag. You’re just not-- you can’t. So, you got to have faith and trust. And that’s a giant leap too. Because initially, when we do treatment with people, however we do it, they’ve got to be doing something they don’t know is going to be helpful. 

When people start doing the singing thing or the writing down thing, for instance, after a while, they go, “Wow, that really worked. Okay, I’m going to do that some more.” And that’s what we need. Initially, you just have to have faith and experiment. That’s why we like to do short experiments. I don’t say, “Hey, do this over the next 12 weeks and you’ll get better.” I go, “Look, I know you think this over here, I’m thinking it’s this over here. How about we structure something for the next X number of minutes, hours, days, and just see what you notice if you can feel like you can afford to do that.” 

Kimberley: So good. I’ve just got one question and then I’m going to let you go. I’m going to first ask my question and then I want you to explain, tell us about your course. When you sing the song, I usually have my staff sing it to a song they know, like Happy Birthday or Auld Lang Syne, whatever it may be. You are saying just up and down, “No, no, no,” that kind of thing. Is there a reason for that?

Reid: Well, I don’t want people to have to make a rhyme. I don’t want them to have to--

Kimberley: It’s just for the sake of it.

Reid: I’m totally fine with what you’re saying. Okay, I’m going to-- you can figure it out. It’s like going, “Okay, anytime I hear my obsession come up, I’m going to make my obsession the voice of Minnie Mouse. So, I’m going to degrade it by having to be a little mouse on my shoulder, anything to degrade it.” If you’ve got to set little songs or you ask your client what they would put it to, then yeah. And then in the session, we’re talking about the therapist, demonstrate it and have them practice it with you in order to get it.

Kimberley: Right. I’ve even had clients who are good at accents, like do it in different accents. They bring out--

Reid: You’ve got a good one. You’re really practicing that Australian accent.

Kimberley: Very. I practiced for many years to get this one. All right. You talk about the six-moment game. I’ve had the joy of having taken that course. Can you tell us if that’s what you want to tell us about, about where people can hear about you and all the good stuff you’ve got?

Reid: Sure. Well, I would start with just saying anxieties.com. It’s anxieties, plural, .com. And that’s my website, a free website. It’s got every anxiety disorder and OCD. You’ve got written instruction around how to do some of the work that we’re talking about. And then I’ve got tons of free video clips that people can watch and learn a bunch of stuff. I laid out, in the last two years, a four-hour course, and I filmed it. And so, it is online now. I take people all the way through what I call OCD & the 6-Moment Game: Strategies and Tactics, because I want to empower people in that way. So, I talk about all the stuff that you and I are rushing over right now. It’s got a full written transcript as an eBook, a PDF eBook. I’ve got a workbook that lets people figure out how to do these practices on their own. All of that. In fact, you can get-- I can’t say how to get it at this moment. Maybe you can post something, I don’t know. But I will give anybody the workbook, that’s 37 pages, and it takes you through a bunch of stuff. No cost to you, send it to anybody else you want. 

So, I feel like that, first off, we don’t have enough mental health professionals to treat the people with mental health disorders in this world today. And so, we need to find delivery systems. That will help reach more people. And I believe in Stepped Care. And Stepped Care is a protocol, both in physical medicine and in mental health, which says that first step of Stepped Care and treatment is self-help. And I call it self-help treatment, because the first step is relatively inexpensive, empowering the patient or the client, and giving them directions about how to get stronger. And a certain percentage of people, that will be enough for them. And so, all of us who have written self-help books and so forth, that’s our intention. And now, I’m trying to go one step beyond self-help books to be able to have video that gives people more in-depth. 

What I want is for that first step, the principles that are in that first step, go up to the next step. So, if a self-help course or a book or whatever is not sufficient to finish the work, then you go up one level to maybe a self-help group or a therapeutic group and work further there. And if you can’t complete your work, then go up the next step, which is individual treatment, the next step, which is intensive outpatient treatment, the next step, mixture medications, and so forth. And so, if we can carry a set of principles up, then everybody’s on the same page and you’re not starting all over again. So, I focus on step one. I’m a simple guy.

Kimberley: I’m focused on step one too, which is what you’re doing with me right now, which makes me so happy. I’m so grateful for you for so many reasons.

Reid: Well, I’m happy to be doing this, spending time with you. It’s great. And trying to figure out how to deliver the information concisely. It’s still a work in progress. Thank you for giving me an opportunity.

Kimberley: No, thank you. I’ve loved hearing about all of these major points of your work. I’m so grateful for you. So, thank you so much for coming on again. I didn’t have a coughing fit during this episode like I did the last one.

Reid: Nothing to make fun of you about.

Kimberley: Thank you so much, Reid. You’re just the best.

Reid: Well, great constructing this whole thing. This is what I’m talking about too, is to have a series of us that eventually everybody will see and work their way down and get all these different positions and opinions from people who already do this work. And so, that’s great. You have a choice, so that’s great.

Kimberley: Love it. Thank you.

Reid: Okay. Talk again sometime.

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